Procoagulant fusion compound

ABSTRACT

The present invention provides a fusion compound comprising a procoagulant compound and an immunoglobulin constant region or a portion thereof and methods of making and using the fusion compound. The fusion compounds of the present disclosure are useful for the treatment of coagulation disorders, such as hemophilia. In some aspects, the invention includes a method of reducing or preventing aggregates which comprise a procoagulant compound comprising fusing the procoagulant compound to an immunoglobulin constant region or a portion thereof wherein the procoagulant compound comprises an amino acid sequence. In another embodiment, the fusion compound forms less aggregates compared to a compound consisting of the procoagulant compound.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to procoagulant compounds useful for the treatment of coagulation disorders, such as hemophilia A and B.

2. Background of the Invention

The blood coagulation pathway, in part, involves the formation of an enzymatic complex of Factor VIIIa (FVIIIa) and Factor IXa (FIXa) (Xase complex) on the surface of platelets. FIXa is a serine protease with relatively weak catalytic activity without its cofactor FVIIIa. The Xase complex cleaves Factor X (FX) into Factor Xa (FXa), which in turn interacts with Factor Va (FVa) to cleave prothrombin and generate thrombin.

Hemophilia A is a bleeding disorder caused by mutations and/or deletions in the Factor VIII (FVIII) gene resulting in a deficiency of FVIII activity. In some cases, patients have reduced levels of FVIII due to the presence of FVIII inhibitors, such as anti-FVIII antibodies. Hemophilia B (also known as Christmas disease) is one of the most common inherited bleeding disorders in the world. It results in decreased in vivo and in vitro blood clotting activity and requires extensive medical monitoring throughout the life of the affected individual.

Hemophilia A can be treated by replacement therapy targeting restoration of FVIII activity to 1 to 5% of normal levels to prevent spontaneous bleeding. There are plasma-derived and recombinant FVIII products available to treat bleeding episodes on-demand or to prevent bleeding episodes from occurring by treating prophylactically.

Hemophilia B is caused by a deficiency in Factor IX that may result from either the decreased synthesis of the Factor IX protein or a defective molecule with reduced activity. The treatment of hemophilia B occurs by replacement of the missing clotting factor by exogenous factor concentrates highly enriched in Factor IX.

Reduced mortality, prevention of joint damage and improved quality of life have been important achievements due to the development of plasma-derived and recombinant clotting factors. However, there remains a great need for improved procoagulant therapies for the treatment (e.g., prophylactic treatment) of hemophilia and other blood coagulation disorders that are more tolerable, effective, and/or convenient than current therapies.

BRIEF SUMMARY OF THE INVENTION

The present invention provides a fusion compound comprising a procoagulant compound fused to an immunoglobulin constant region or a portion thereof, wherein the procoagulant compound comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).

In some aspects, the invention includes a method of reducing or preventing aggregates which comprise a procoagulant compound comprising fusing the procoagulant compound to an immunoglobulin constant region or a portion thereof, wherein the procoagulant compound comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).

In one embodiment, the procoagulant compound comprises SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).

In another embodiment, the fusion compound forms less aggregates compared to a compound consisting of the procoagulant compound. In other embodiments, the fusion compound forms at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 100% less aggregates compared to a compound consisting of the procoagulant compound.

In some embodiments, the immunoglobulin constant region or a portion thereof in the fusion compound is an Fc fragment or an FcRn binding partner. In other embodiments, the procoagulant compound is linked to the immunoglobulin constant region or a portion thereof by a linker. In some embodiments, the procoagulant compound in the fusion compound comprises a free N-terminal.

In other embodiments, the linker comprises (GGGGS), (SEQ ID NO: 22), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., (GGGGS)₆ (SEQ ID NO: 24).

In still other embodiments, the fusion compound comprises the procoagulant compound, an immunoglobulin constant region or a portion thereof which is linked to the procoagulant compound, and an additional immunoglobulin constant region or a portion thereof, wherein the additional immunoglobulin constant region or a portion thereof is covalently linked to the immunoglobulin constant region or a portion thereof. In still other embodiments, the additional immunoglobulin constant region or a portion thereof is linked to the immunoglobulin constant region or a portion thereof by a second linker. In a particular embodiment, the second linker is (GGGGS), (SEQ ID NO: 22), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., (GGGGS)₄ (SEQ ID NO: 23).

In other embodiments, the fusion compound comprises amino acids 22 to 558 of SEQ ID NO: 2 or the amino acid sequence encoded by a nucleotide sequence of SEQ ID NO: 1.

The invention also includes a polynucleotide sequence encoding a fusion compound, a vector comprising the polynucleotide sequence, a pharmaceutical composition comprising the fusion compound, the vector, or the polynucleotide sequences, or the host cell comprising the polynucleotide sequence.

Also provided is a method of making a fusion compound comprising the procoagulant compound fused to an immunoglobulin constant region or a portion thereof, the method comprising culturing a host cell comprising a polynucleotide encoding the procoagulant compound which comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3) under suitable condition, wherein the fusion compound is expressed. In other embodiments, the invention includes a method of reducing, ameliorating, or preventing a bleeding episode in a subject in need thereof comprising administering the fusion compound, the polynucleotide sequence, the vector, or the host cell to the subject.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A shows a schematic diagram of Fc-048 comprising a procoagulant compound (SYN4022) linked to a first Fc region by a linker (e.g., (GGGGS)₆) (SEQ ID NO: 24), in which the first Fc region is further linked to a second Fc region by a second linker (e.g., (GGGGS)₄) (SEQ ID NO: 23). FIG. 1B shows a schematic diagram of a linker capped analog of Fc-048, i.e., Fc-050, which comprises a procoagulant compound linked to a first Fc region by a first linker through its C-terminal and to a second Fc region by a second linker through its N-terminal.

FIG. 2 shows analytical SEC spectra of isolated monomeric, medium and large aggregate of Fc-048 after 5 g infection of each fusion compound.

FIG. 3A shows TGA profile of Fc-048 containing a mixture of monomer and aggregates. The top peak is for Fc-048 1 μM; the second peak is for Fc-048 0.333 μM; the third peak is for Fc-048 0.111 μM, the fourth peak is for Fc-048 0.037 μM; the fifth peak is for Fc-048 0.0123 μM; the sixth peak is for Fc-048 0.0041 μM; the seventh peak is for Fc-048 0.0014 μM; and the last peak is plasma alone. FIG. 3B shows TGA profile of Fc-050 containing a mixture of monomer and aggregates. The top peak is for Fc-050 0.14 μM; the second peak is for Fc-050 0.29 μM; the third peak is for plasma alone, the fourth peak is for Fc-050 0.57 μM; the fifth peak is for Fc-050 1.14 μM; the sixth peak is for Fc-050 4.57 μM; the seventh peak is for 2.29 μM.

FIG. 4 shows TGA profile of isolated monomeric and aggregate Fc-048.

FIG. 5 is a diagram showing the mouse plasma levels of Fc-048 (expressed as percentages of initial dose) over the course of 6 days following intravenous injection of 1.15 mg/kg in hemophilia A mice.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides a fusion compound comprising a procoagulant compound fused to an immunoglobulin constant region or a portion thereof and methods of making and using thereof.

I. Definitions

It must be noted that, as used in this specification and the appended claims, the singular forms “a”, “an” and “the” include plural referents unless the context clearly dictates otherwise. The terms “a” (or “an”), as well as the terms “one or more,” and “at least one” can be used interchangeably herein.

The term “about” is used herein to mean approximately, roughly, around, or in the regions of. When the term “about” is used in conjunction with a numerical range, it modifies that range by extending the boundaries above and below the numerical values set forth. In general, the term “about” is used herein to modify a numerical value above and below the stated value by a variance of 10 percent, up or down (higher or lower).

Furthermore, “and/or” where used herein is to be taken as specific disclosure of each of the two specified features or components with or without the other. Thus, the term “and/or” as used in a phrase such as “A and/or B” herein is intended to include “A and B,” “A or B,” “A” (alone), and “B” (alone). Likewise, the term “and/or” as used in a phrase such as “A, B, and/or C” is intended to encompass each of the following embodiments: A, B, and C; A, B, or C; A or C; A or B; B or C; A and C; A and B; B and C; A (alone); B (alone); and C (alone).

It is understood that wherever embodiments are described herein with the language “comprising,” otherwise analogous embodiments described in terms of “consisting of” and/or “consisting essentially of” are also provided.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure is related. For example, the Concise Dictionary of Biomedicine and Molecular Biology, Juo, Pei-Show, 2nd ed., 2002, CRC Press; The Dictionary of Cell and Molecular Biology, 3rd ed., 1999, Academic Press; and the Oxford Dictionary Of Biochemistry And Molecular Biology, Revised, 2000, Oxford University Press, provide one of skill with a general dictionary of many of the terms used in this disclosure.

Units, prefixes, and symbols are denoted in their Syst{tilde over (e)}me International de Unites (SI) accepted form. Numeric ranges are inclusive of the numbers defining the range. Unless otherwise indicated, amino acid sequences are written left to right in amino to carboxy orientation. The headings provided herein are not limitations of the various aspects or embodiments of the disclosure, which can be had by reference to the specification as a whole. Accordingly, the terms defined immediately below are more fully defined by reference to the specification in its entirety. Amino acids are referred to herein by either their commonly known three letter symbols or by the one-letter symbols recommended by the IUPAC-IUB Biochemical Nomenclature Commission. Nucleotides, likewise, are referred to by their commonly accepted single-letter codes.

The terms “polypeptide,” “peptide” and “protein” are used interchangeably and refer to a polymeric compound comprised of covalently linked amino acid residues.

The terms “polynucleotide” and “nucleic acid” are used interchangeably and refer to a polymeric compound comprised of covalently linked nucleotide residues. Polynucleotides can be DNA, cDNA, RNA, single stranded, or double stranded, vectors, plasmids, phage, or viruses. Polynucleotides include the sequence in SEQ ID NO: 1, which encode the polypeptides of SEQ ID NO: 2. Polynucleotides also include fragments of the polynucleotides of SEQ ID NO: 1, e.g., those that encode fragments of the polypeptides of SEQ ID NO: 2, such as the procoagulant compound, Fc, signal sequence, and other fragments of the polypeptides of SEQ ID NO: 2.

“Administering,” as used herein, means to proscribe or give a pharmaceutically acceptable fusion compound of the invention to a subject via a pharmaceutically acceptable route. Examples of routes of administration include, but are not limited to, intravenous, e.g., intravenous injection and intravenous infusion, e.g., via central venous access. Additional routes of administration include subcutaneous, intramuscular, oral, nasal, and pulmonary administration.

The term “treatment” or “treating” as used herein means amelioration or reduction of one or more symptoms of bleeding diseases or disorders including, but not limited to, hemophilia. In one embodiment, “treatment of” or “treating” a bleeding disease or disorder includes prevention of one or more symptoms of a bleeding disease or disorder. In other embodiments, “treatment” or “treating” means reduction of the frequency of one or more symptoms of bleeding diseases or disorders, e.g., spontaneous or uncontrollable bleeding episodes. “Treatment,” however, need not be a cure.

“Subject,” as used herein means a human or a non-human mammal. Non-human mammals include, e.g., mice, dogs, primates, monkeys, cats, horses, cows, pigs, and other domestic animals and small animals. In one embodiment, the “subject” is a human patient. Subject as used herein includes an individual who is known to have at least one incidence of uncontrolled bleeding episodes, who has been diagnosed with a disease or disorder associated with uncontrolled bleeding episodes, e.g., a bleeding disease or disorder, e.g., hemophilia, who is susceptible to uncontrolled bleeding episodes, e.g., hemophilia, or any combinations thereof. Subjects can also include an individual who is in danger of one or more uncontrollable bleeding episodes prior to a certain activity, e.g., a surgery, a sport activity, or any strenuous activities.

The term “bleeding episode” as used herein adopts a standardized definition of a bleeding episode. A bleeding episode started from the first sign of bleeding, and ended 72 hours after the last treatment for the bleeding, within which any symptoms of bleeding at the same location, or injections less than or equal to 72 hours apart, were considered the same bleeding episode. Any injection to treat the bleeding episode, taken more than 72 hours after the preceding one, was considered the first injection to treat a new bleeding episode at the same location. Any bleeding at a different location was considered a separate bleeding episode regardless of time from last injection. This definition has been proposed by the Subcommittee on Standards and Criteria, FVIII/FIX subcommittee of the International Society of Thrombosis and Hemostasis and has been used by the PedNet multicenter study in hemophilia.

As used herein, the term “pharmaceutically acceptable” means approved by a regulatory agency of US or EU or other government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in humans. Hence, the term “pharmaceutically acceptable” refers to those properties and/or substances that are acceptable to a patient (e.g., human patient) from a toxicological and/or safety point of view.

The term compound and molecule are used interchangeably. Other forms contemplated by the invention when the word “molecule” or “compound” is employed are salts, prodrugs, solvates, tautomers, stereoisomers and mixtures of stereoisomers. The compounds of this invention can be in the form of a pharmaceutically acceptable salt.

The term “amino acid” within the scope of the present invention means alpha-amino acid unless otherwise specified. The term “amino acid” includes naturally occurring, and non-naturally occurring (i.e., non-proteinogenic) amino acids. The one and three letter abbreviations for naturally occurring amino acids are used herein (see, e.g., Lehninger, Biochemistry, 2nd ed., Worth Publishers, New York, 1995: 71-92). The term “amino acid” also includes stereoisomers (for example D-amino acids) and modifications of naturally occurring amino acids (e.g., alpha-N-alkylated amino acids; modified phenylalanine or tyrosine derivatives, and the like).

Conventionally, L-amino acids are designated using upper case letters (e.g., the upper case letter “C” refers to L-cysteine), and D-amino acids are designated in lower case (e.g., the lower case letter “c” refers to D-cysteine). Where no indication of the isomer is given, both isomers are intended. For example, when the amino acid is referred to with its name, both L- and D-amino acids are included (e.g., the term “cysteine” includes both, L-cysteine and D-cysteine).

The term “modified amino acid” refers to amino acids, which are altered with respect to their original structure, e.g., by substitution. Examples of modified amino acids include, e.g., alpha-N-alkylated amino acids, tyrosine derivatives (e.g., those in which the hydroxyl group is converted to an ether or ester group, or those in which the phenyl ring is substituted, e.g., with a halogen atom), phenylalanine derivatives (e.g., those in which the phenyl ring is substituted, e.g., with a halogen atom), lysine derivatives (e.g., those in which the NH₂ group is converted to an amide group or sulfonamide group), and amino acids, in which a carboxylic acid group is derivatized, e.g., esterified, converted to an amide group, and the like. In one example, the modified amino acid is a tyrosine residue modified at the hydroxyl group and having the formula Y—OR^(b), wherein R^(b) is selected from straight or branched alkyl, e.g., (C₁-C₁₀)alkyl, straight or branched heteroalkyl, e.g., (C₁-C₁₀)heteroalkyl comprising from 1 to 5 heteroatoms selected from O, S and N, and a water-soluble polymer (e.g., a PEG moiety). In another example, the modified tyrosine is methoxy-tyrosine (Y—OMe).

Introduction of at least one non-natural amino acid, or modification of at least one amino acid can improve the stability or solubility of a peptide. It can further increase the resistance to protease degradation or alter the biological (e.g., in vitro biological) activity of the peptide.

Other modified and non-proteinogenic amino acids useful in the present invention are described, e.g., in Grant, Synthetic Peptides: A Users Guide. Oxford University Press, 1992, which is incorporated herein by reference in its entirety.

Non-proteinogenic amino acids may include but are not limited to norvaline (Nva), norleucine (Nle), 4-aminobutyric acid (gamma-Abu), 2-aminoisobutyric acid (Aib), 6-aminohexanoic acid (gamma-Ahx), ornithine (Orn), hydroxyproline (Hyp), sarcosine, citrulline, cysteic acid (Coh), cyclohexylalanine, methioninesulfoxide (Meo), methioninesulfone (Moo), homoserinemethylester (Hsm), propargylglycine (Eag), 5-fluorotryptophan (5Fw), 6-fluorotryptophan (6Fw), 3′,4′-dimethoxyphenyl-alanine (Ear), 3′,4′-difluorophenylalanine (Dff), 4′-fluorophenyl-alanine (Pff), 1-naphthyl-alanine (1-Nal), 1-naphthyl-alanine, 1-methyltryptophan (1Mw), penicillamine (Pen), homoserine (HSe). Further, such amino acids may include but are not limited to, alpha-amino isobutyric acid, t-butylglycine, t-butylalanine, phenylglycine (Phg), benzothienylalanine (Bta), L-homo-cysteine (L-Hcys), N-methyl-phenylalanine (NMF), 2-thienylalanine (Thi), 3,3-diphenylalanine (Ebw), homophenylalanine (Hfe), s-benzyl-L-cysteine (Ece) or cyclohexylalanine (Cha). These and other non-proteinogenic amino acids may exist as D- or L-isomers.

The term “inverso-variant” of a peptide as used in this application means an enantiomer or mirror-image of a peptide. An “inverso-variant” is a peptide having the same amino acid sequence as its corresponding native peptide, but includes the corresponding D-amino acid for each L-amino acid in the native peptide, and the corresponding L-amino acid for each D-amino acid present in the native peptide (i.e., the chirality for each amino acid is inverted).

The term “retro-variant” of a peptide, means a peptide having the same amino acid sequence but in which the amino acids are assembled in opposite direction (reverse order) to the native peptide.

The term “retro-inverso variant” as used in this application means a retro-peptide as described herein, which is also reversed in its amino acid sequence as in a retro-variant described herein. Thus, a “retro-inverso variant” of a peptide refers to a peptide is made up of amino acid residues which are assembled in the opposite direction and which have inverted chirality with respect to the native peptide to which it is retro-inverso modified.

A retro-inverso variant can maintain the topology of the side chains as in the native peptide sequence. For example, Guichard et al. (1994) Proc. Natl. Acad. Sci. USA 91:9765-9769 described that a retro-inverso peptide mimicked the structure and antigenic activity of the natural L-peptide IRGERA, but not of the D- and retro peptides. Such retro-inverso peptidomimetics may be made using methods known in the art, for example such as those described in Meziere et al. (1997) J. Immunol. 159, 3230-3237, incorporated herein by reference in its entirety. Partial retro-inverso peptide analogues are polypeptides in which only part of the sequence is reversed and replaced with enantiomeric amino acid residues. Processes for making such analogues are described, e.g., in European Patent EP0097994 to Pessi et al., which is incorporated by reference herein in its entirety.

Conventionally, where the amino acids are joined by peptide bonds, a peptide is represented such that the amino group at the N-terminus appears to the left and the carboxyl group at the C-terminus to the right. Peptides and peptide derivatives according to the present invention are represented in this manner.

A “peptide derivative” contains a modification of one or more amino acid residues or a linker group or other covalently linked group. Examples of amino acid derivatives include N-acyl derivatives of the amino terminal or of another free amino group, esters of the carboxyl terminal or of another free carboxyl or hydroxy group, amides of the carboxyl terminal or of another free carboxyl group produced by reaction with ammonia or with a suitable amine, glycosylated derivatives, hydroxylated derivatives, nucleotidylated derivatives, ADP-ribosylated derivatives, pegylated derivatives, phosphorylated derivatives, biotinylated derivatives, derivatives conjugated to an antibody or antibody fragment, albumin, transferrin, HES, and the like. Also included among the chemical derivatives are those obtained by modification of the peptide bond —CO—NH—, for example by reduction to —CH₂—NH— or alkylation to —CO—N(alkyl)-. Other derivatives include amide bond bioisosteres, ketomethylene and hydroxyethylene derivatives, as well as thioesters, thioamides and the like.

Other modifications include, e.g., acetylation, acylation, ADP-ribosylation, amidation, covalent attachment of flavin, covalent attachment of a heme moiety, covalent attachment of a nucleotide or nucleotide derivative, covalent attachment of phosphotidylinositol, cross-linking, cyclization, disulfide bond formation, demethylation, formation of covalent cross-links, formation of cysteine, formation of pyroglutamate, formylation, gamma-carboxylation, glycosylation, GPI anchor formation, hydroxylation, halogenation (e.g., iodination), methylation, myristoylation, oxidation, pegylation (Mei et al., Blood 116:270-79 (2010), which is incorporated herein by reference in its entirety), proteolytic processing, phosphorylation, prenylation, racemization, selenoylation, sulfation, transfer-RNA mediated addition of amino acids to proteins such as arginylation, and ubiquitination.

In one example, derivatisation is C-terminal amidation. C-terminal amidation of a peptide removes the negative charge of the C-terminal carboxyl group. Peptide derivatives having a C-terminal amide can be represented with “NH₂” at the C-terminus, for example SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA-NH₂. Another derivatisation is N-terminal acetylation. This removes the positive charge at the N-terminus. Blocking of the C- or N-terminus, such as by C-terminal amidation or N-terminal acetylation, may improve proteolytic stability due to reduced susceptibility to exoproteolytic digestion.

By “procoagulant activity” is meant the ability to promote thrombin generation and/or fibrin deposition in a suitable test system. Exemplary assays useful to measure the procoagulant activity of a fusion compound of the present invention are described herein and include, e.g., thrombin generation assays.

The term “antibody variant” or “modified antibody” includes an antibody which does not occur in nature and which has an amino acid sequence or amino acid side chain chemistry which differs from that of a naturally-derived antibody by at least one amino acid or amino acid modification as described herein. As used herein, the term “antibody variant” includes synthetic forms of antibodies which are altered such that they are not naturally occurring, e.g., antibodies that comprise at least two heavy chain portions but not two complete heavy chains (such as, domain deleted antibodies or minibodies); multispecific forms of antibodies (e.g., bispecific, trispecific, etc.) altered to bind to two or more different antigens or to different epitopes on a single antigen); heavy chain molecules joined to scFv molecules; single-chain antibodies; diabodies; triabodies; and antibodies with altered effector function and the like.

The term “procoagulant compound” or “procoagulant compound of the invention” as used herein including plural forms shall mean an amino acid sequence having at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3), or a variant or derivative of SEQ ID NO: 3.

As used herein the term “scFv molecule” includes binding molecules which consist of one light chain variable domain (VL) or portion thereof, and one heavy chain variable domain (VH) or portion thereof, wherein each variable domain (or portion thereof) is derived from the same or different antibodies. scFv molecules can comprise an scFv linker interposed between the VH domain and the VL domain. ScFv molecules are known in the art and are described, e.g., in U.S. Pat. No. 5,892,019, Ho et al. 1989. Gene 77:51; Bird et al. 1988 Science 242:423; Pantoliano et al. 1991. Biochemistry 30:10117; Milenic et al. 1991. Cancer Research 51:6363; Takkinen et al. 1991. Protein Engineering 4:837.

A “scFv linker” as used herein refers to a moiety interposed between the VL and VH domains of the scFv. scFv linkers can maintain the scFv molecule in an antigen binding conformation. In one embodiment, an scFv linker comprises or consists of an scFv linker peptide. In certain embodiments, an scFv linker peptide comprises or consists of a gly-ser polypeptide linker. In other embodiments, an scFv linker comprises a disulfide bond.

As used herein the term “disulfide bond” includes the covalent bond formed between two sulfur atoms. The amino acid cysteine comprises a thiol group that can form a disulfide bond or bridge with a second thiol group. In most naturally occurring IgG molecules, the CH1 and CL regions are linked by native disulfide bonds and the two heavy chains are linked by two native disulfide bonds at positions corresponding to 239 and 242 using the Kabat numbering system (position 226 or 229, EU numbering system).

The term “vector” or “expression vector” is used herein to mean vectors used in accordance with the present invention as a vehicle for introducing into and expressing a desired polynucleotide in a cell. As known to those skilled in the art, such vectors may easily be selected from plasmids, phages, viruses and retroviruses. In general, vectors compatible with the instant invention will comprise a selection marker, appropriate restriction sites to facilitate cloning of the desired gene and the ability to enter and/or replicate in eukaryotic or prokaryotic cells.

Numerous expression vector systems may be employed to produce the fusion compounds of the invention. For example, one class of vector utilizes DNA elements which are derived from animal viruses such as bovine papilloma virus, polyoma virus, adenovirus, vaccinia virus, baculovirus, retroviruses (RSV, MMTV or MOMLV) or SV40 virus. Additionally, cells which have integrated the DNA into their chromosomes may be selected by introducing one or more markers which allow selection of transfected host cells. The marker may provide for prototrophy to an auxotrophic host, biocide resistance (e.g., antibiotics) or resistance to heavy metals such as copper. The selectable marker gene can either be directly linked to the DNA sequences to be expressed, or introduced into the same cell by cotransformation. In one embodiment, an inducible expression system can be employed. Additional elements may also be needed for optimal synthesis of mRNA. These elements may include signal sequences, splice signals, as well as transcriptional promoters, enhancers, and termination signals. In one embodiment, a secretion signal, e.g., any one of several well characterized bacterial leader peptides (e.g., pelB, phoA, or ompA), can be fused in-frame to the N terminus of a polypeptide of the invention to obtain optimal secretion of the polypeptide. (Lei et al. (1988), Nature, 331:543; Better et al. (1988) Science, 240:1041; Mullinax et al., (1990). PNAS, 87:8095).

The term “host cell” refers to a cell that has been transformed with a vector constructed using recombinant DNA techniques and encoding at least one heterologous gene. In descriptions of processes for isolation of proteins from recombinant hosts, the terms “cell” and “cell culture” are used interchangeably to denote the source of protein unless it is clearly specified otherwise. In other words, recovery of protein from the “cells” may mean either from spun down whole cells, or from the cell culture containing both the medium and the suspended cells. The host cell line used for protein expression can be of mammalian origin; those skilled in the art are credited with ability to preferentially determine particular host cell lines which are best suited for the desired gene product to be expressed therein. Exemplary host cell lines include, but are not limited to, DG44 and DUXB11 (Chinese Hamster Ovary lines, DHFR minus), HELA (human cervical carcinoma), CVI (monkey kidney line), COS (a derivative of CVI with SV40 T antigen), R1610 (Chinese hamster fibroblast) BALBC/3T3 (mouse fibroblast). HAK (hamster kidney line), SP2/O (mouse myeloma), P3x63-Ag3.653 (mouse mycloma), BFA-1c1BPT (bovine endothelial cells), RAJI (human lymphocyte) and 293 (human kidney). In a specific embodiment, the host cell is HEK293 cells. Host cell lines are typically available from commercial services, the American Tissue Culture Collection or from published literature. The fusion compounds of the invention can also be expressed in non-mammalian cells such as bacteria or yeast or plant cells. In this regard it will be appreciated that various unicellular non-mammalian microorganisms such as bacteria can also be transformed; i.e., those capable of being grown in cultures or fermentation. Bacteria, which are susceptible to transformation, include members of the enterobacteriaceae, such as strains of Escherichia coli or Salmonella; Bacillaceae, such as Bacillus subtilis; Pneumococcus; Streptococcus, and Haemophilus influenzae. It will further be appreciated that, when expressed in bacteria, the polypeptides typically become part of inclusion bodies. The fusion compound must be isolated, purified and then assembled into functional molecules.

In addition to prokaryotes, eukaryotic microbes may also be used. Saccharomyces cerevisiae, or common baker's yeast, is the most commonly used among eukaryotic microorganisms although a number of other strains are commonly available including Pichia pastoris. For expression in Saccharomyces, the plasmid YRp7, for example, (Stinchcomb et al., (1979), Nature, 282:39; Kingsman et al., (1979), Gene, 7:141; Tschemper et al., (1980), Gene, 10:157) is commonly used. This plasmid already contains the TRP1 gene which provides a selection marker for a mutant strain of yeast lacking the ability to grow in tryptophan, for example ATCC No. 44076 or PEP4-1 (Jones, (1977), Genetics, 85:12). The presence of the trpl lesion as a characteristic of the yeast host cell genome then provides an effective environment for detecting transformation by growth in the absence of tryptophan.

As used herein, the term “cleavage site” refers to a site recognized by an enzyme. In one embodiment, such an enzyme is one that is activated during the clotting cascade, such that cleavage of such sites occurs at the site of clot formation. Exemplary such sites include those recognized by thrombin, Factor XIa or Factor Xa

In constructs that include more than one processing or cleavage site, it will be understood that such sites may be the same or different.

“Blood coagulation factor” or “coagulation factor” as used herein means FVIIa, FVIII, or FIX.

“Culture,” “to culture” and “culturing,” as used herein, means to incubate cells under in vitro conditions that allow for cell growth or division or to maintain cells in a

“Variant,” as used herein, refers to a polynucleotide or polypeptide differing from the original polynucleotide or polypeptide, but retaining essential properties thereof, e.g., FVIII coagulant activity or Fc (FcRn binding) activity. Generally, variants are overall closely similar, and, in many regions, identical to the original polynucleotide or polypeptide. Variants include, e.g., polypeptide and polynucleotide fragments, deletions, insertions, and modified versions of original polypeptides.

Naturally occurring variants are called “allelic variants,” and refer to one of several alternate forms of a gene occupying a given locus on a chromosome of an organism (Genes II, Lewin, B., ed., John Wiley & Sons, New York (1985)). These allelic variants can vary at either the polynucleotide and/or polypeptide level and are included in the present invention. Alternatively, non-naturally occurring variants may be produced by mutagenesis techniques or by direct synthesis.

Using known methods of protein engineering and recombinant DNA technology, variants may be generated to improve or alter the characteristics of the polypeptides. For instance, one or more amino acids can be deleted from the N-terminus or C-terminus of the secreted protein without substantial loss of biological function. The authors of Ron et al., J. Biol. Chem. 268: 2984-2988 (1993), incorporated herein by reference in its entirety, reported variant KGF proteins having heparin binding activity even after deleting 3, 8, or 27 amino-terminal amino acid residues. Similarly, Interferon gamma exhibited up to ten times higher activity after deleting 8-10 amino acid residues from the carboxy terminus of this protein. (Dobeli et al., J. Biotechnology 7:199-216 (1988), incorporated herein by reference in its entirety.)

Moreover, ample evidence demonstrates that variants often retain a biological activity similar to that of the naturally occurring protein. For example, Gayle and coworkers (J. Biol. Chem 268:22105-22111 (1993), incorporated herein by reference in its entirety) conducted extensive mutational analysis of human cytokine IL-1a. They used random mutagenesis to generate over 3,500 individual IL-1a mutants that averaged 2.5 amino acid changes per variant over the entire length of the molecule. Multiple mutations were examined at every possible amino acid position. The investigators found that “most of the molecule could be altered with little effect on either binding or biological activity.” In fact, only 23 unique amino acid sequences, out of more than 3,500 nucleotide sequences examined, produced a protein that significantly differed in activity from wild-type.

As stated above, polypeptide variants include, e.g., modified polypeptides. Modifications include, e.g., acetylation, acylation, ADP-ribosylation, amidation, covalent attachment of flavin, covalent attachment of a heme moiety, covalent attachment of a nucleotide or nucleotide derivative, covalent attachment of a lipid or lipid derivative, covalent attachment of phosphotidylinositol, cross-linking, cyclization, disulfide bond formation, demethylation, formation of covalent cross-links, formation of cysteine, formation of pyroglutamate, formylation, gamma-carboxylation, glycosylation, GPI anchor formation, hydroxylation, iodination, methylation, myristoylation, oxidation, pegylation (Mei et al., Blood 116:270-79 (2010), which is incorporated herein by reference in its entirety), proteolytic processing, phosphorylation, prenylation, racemization, selenoylation, sulfation, transfer-RNA mediated addition of amino acids to proteins such as arginylation, and ubiquitination.

By a nucleic acid having a nucleotide sequence at least, for example, 95% “identical” to a reference nucleotide sequence, it is intended that the nucleotide sequence of the nucleic acid is identical to the reference sequence except that the nucleotide sequence may include up to five point mutations per each 100 nucleotides of the reference nucleotide sequence. In other words, to obtain a nucleic acid having a nucleotide sequence at least 95% identical to a reference nucleotide sequence, up to 5% of the nucleotides in the reference sequence may be deleted or substituted with another nucleotide, or a number of nucleotides up to 5% of the total nucleotides in the reference sequence may be inserted into the reference sequence.

By a polypeptide having an amino acid sequence at least, for example, 95% “identical” to a query amino acid sequence of the present invention, it is intended that the amino acid sequence of the subject polypeptide is identical to the query sequence except that the subject polypeptide sequence may include up to five amino acid alterations per each 100 amino acids of the query amino acid sequence. In other words, to obtain a polypeptide having an amino acid sequence at least 95% identical to a query amino acid sequence, up to 5% of the amino acid residues in the subject sequence may be inserted, deleted, (indels) or substituted with another amino acid. These alterations of the reference sequence may occur at the amino or carboxy terminal positions of the reference amino acid sequence or anywhere between those terminal positions, interspersed either individually among residues in the reference sequence or in one or more contiguous groups within the reference sequence.

As a practical matter, whether any particular nucleic acid molecule or polypeptide is at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to a nucleotide sequence or polypeptide of the present invention can be determined conventionally using known computer programs. A preferred method for determining the best overall match between a query sequence (reference or original sequence) and a subject sequence, also referred to as a global sequence alignment, can be determined using the FASTDB computer program based on the algorithm of Brutlag et al. (Comp. App. Biosci. (1990) 6:237-245). In a sequence alignment the query and subject sequences are both DNA sequences. An RNA sequence can be compared by converting U's to T's. The result of said global sequence alignment is in percent identity. Preferred parameters used in a FASTDB alignment of DNA sequences to calculate percent identity are: Matrix=Unitary, k-tuple=4, Mismatch Penalty=1, Joining Penalty=30, Randomization Group Length=0, Cutoff Score=1, Gap Penalty=5, Gap Size Penalty 0.05, Window Size=500 or the length of the subject nucleotide sequence, whichever is shorter.

If the subject sequence is shorter than the query sequence because of 5′ or 3′ deletions, not because of internal deletions, a manual correction must be made to the results. This is because the FASTDB program does not account for 5′ and 3′ truncations of the subject sequence when calculating percent identity. For subject sequences truncated at the 5′ or 3′ ends, relative to the query sequence, the percent identity is corrected by calculating the number of bases of the query sequence that are 5′ and 3′ of the subject sequence, which are not matched/aligned, as a percent of the total bases of the query sequence. Whether a nucleotide is matched/aligned is determined by results of the FASTDB sequence alignment. This percentage is then subtracted from the percent identity, calculated by the above FASTDB program using the specified parameters, to arrive at a final percent identity score. This corrected score is what is used for the purposes of the present invention. Only bases outside the 5′ and 3′ bases of the subject sequence, as displayed by the FASTDB alignment, which are not matched/aligned with the query sequence, are calculated for the purposes of manually adjusting the percent identity score.

For example, a 90 base subject sequence is aligned to a 100 base query sequence to determine percent identity. The deletions occur at the 5′ end of the subject sequence and therefore, the FASTDB alignment does not show a matched/alignment of the first 10 bases at 5′ end. The 10 unpaired bases represent 10% of the sequence (number of bases at the 5′ and 3′ ends not matched/total number of bases in the query sequence) so 10% is subtracted from the percent identity score calculated by the FASTDB program. If the remaining 90 bases were perfectly matched the final percent identity would be 90%. In another example, a 90 base subject sequence is compared with a 100 base query sequence. This time the deletions are internal deletions so that there are no bases on the 5′ or 3′ of the subject sequence which are not matched/aligned with the query. In this case the percent identity calculated by FASTDB is not manually corrected. Once again, only bases 5′ and 3′ of the subject sequence which are not matched/aligned with the query sequence are manually corrected for. No other manual corrections are made for the purposes of the present invention.

If the subject sequence is shorter than the query sequence due to N- or C-terminal deletions, not because of internal deletions, a manual correction must be made to the results. This is because the FASTDB program does not account for N- and C-terminal truncations of the subject sequence when calculating global percent identity. For subject sequences truncated at the N- and C-termini, relative to the query sequence, the percent identity is corrected by calculating the number of residues of the query sequence that are N- and C-terminal of the subject sequence, which are not matched/aligned with a corresponding subject residue, as a percent of the total bases of the query sequence. Whether a residue is matched/aligned is determined by results of the FASTDB sequence alignment. This percentage is then subtracted from the percent identity, calculated by the above FASTDB program using the specified parameters, to arrive at a final percent identity score. This final percent identity score is what is used for the purposes of the present invention. Only residues to the N- and C-termini of the subject sequence, which are not matched/aligned with the query sequence, are considered for the purposes of manually adjusting the percent identity score. That is, only query residue positions outside the farthest N- and C-terminal residues of the subject sequence.

For example, a 90 amino acid residue subject sequence is aligned with a 100 residue query sequence to determine percent identity. The deletion occurs at the N-terminus of the subject sequence and therefore, the FASTDB alignment does not show a matching/alignment of the first 10 residues at the N-terminus. The 10 unpaired residues represent 10% of the sequence (number of residues at the N- and C-termini not matched/total number of residues in the query sequence) so 10% is subtracted from the percent identity score calculated by the FASTDB program. If the remaining 90 residues were perfectly matched the final percent identity would be 90%. In another example, a 90 residue subject sequence is compared with a 100 residue query sequence. This time the deletions are internal deletions so there are no residues at the N- or C-termini of the subject sequence which are not matched/aligned with the query. In this case the percent identity calculated by FASTDB is not manually corrected. Once again, only residue positions outside the N- and C-terminal ends of the subject sequence, as displayed in the FASTDB alignment, which are not matched/aligned with the query sequence are manually corrected for. No other manual corrections are to made for the purposes of the present invention.

II. Fusion Compounds

The present invention includes a fusion compound comprising a procoagulant compound and an immunoglobulin constant region or a portion thereof. In one embodiment, the procoagulant compound comprises an amino acid sequence at least 90% or 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3) or a peptide derivative or variant thereof. In another embodiment, the procoagulant compound comprises SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3). In other embodiments, the procoagulant compound useful for the fusion compound comprises a retro-, an inverso- or a retro-inverso variant of the amino acid sequence of SEQ ID NO: 3.

In one embodiment, the fusion compound comprises at least about 90% or 95% identical to amino acids 22 to 558 of SEQ ID NO: 2. In another embodiments, the fusion compound comprises SEQ ID NO: 2. In other embodiments, the fusion compound is encoded by a nucleotide sequence of SEQ ID NO: 1.

In other embodiments, the fusion compound forms less aggregates compared to a compound consisting of the procoagulant compound. For example, the fusion compound forms at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 100% less aggregates compared to a compound consisting of the procoagulant compound.

In some embodiments, the procoagulant compound (P) is linked to an immunoglobulin constant region or a portion thereof (F) by a linker (L), e.g., P-L-F. Non-limiting examples of the linker are shown at the relevant section below. In some embodiments, the linker is a gly-ser polypeptide linker. For example, a procoagulant compound can be linked to an immunoglobulin constant region or a portion thereof by (GGGGS)_(n) (SEQ ID NO: 22), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., (GGGGS)₆ (SEQ ID NO: 24).

In other embodiments, a fusion compound of the invention comprises a procoagulant compound (P) comprising an amino acid sequence at least 90% or 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3), a first immunoglobulin constant region or a portion thereof (F1) linked to the procoagulant compound by a first optional linker (L1), and a second immunoglobulin constant region or a portion thereof (F2) linked to the first immunoglobulin constant region or a portion thereof by a second optional linker (L2). In some embodiments, the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof are covalently linked, e.g., disulfide bond. In one embodiment, the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof are identical. In another embodiment, the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof are different. In other embodiments, the first linker and the second linker are identical or different.

In certain aspects, the immunoglobulin constant region or a portion thereof fused to the compound is at least one Fc region. The term “Fc,” “Fc fragment,” or “Fc region” as used herein, means a functional neonatal Fc receptor (FcRn) binding partner comprising an Fc domain, variant, or fragment thereof which maintains the desirable properties of an Fc region in a chimeric protein, e.g., an increase in in vivo half-life. Myriad mutants, fragments, variants, and derivatives are described, e.g., in PCT Publication Nos. WO 2011/069164 A2, WO 2012/006623 A2, WO 2012/006635 A2, or WO 2012/006633 A2, all of which are incorporated herein by reference in their entireties. An Fc region is comprised of domains denoted CH (constant heavy) domains (CH1, CH2, etc.). Depending on the isotype, (i.e. IgG, IgM, IgA IgD, or IgE), the Fc region can be comprised of three or four CH domains. Some isotypes (e.g. IgG) Fc regions also contain a hinge region. See Janeway et al. 2001, Immunobiology, Garland Publishing, N.Y., N.Y.

An Fc region or a portion thereof for producing the fusion of the present invention can be obtained from a number of different sources. In some embodiments, an Fc region or a portion thereof is derived from a human immunoglobulin. It is understood, however, that the Fc region or a portion thereof can be derived from an immunoglobulin of another mammalian species, including for example, a rodent (e.g. a mouse, rat, rabbit, guinea pig) or non-human primate (e.g. chimpanzee, macaque) species. Moreover, the Fc region or a portion thereof can be derived from any immunoglobulin class, including IgM, IgG, IgD, IgA and IgE, and any immunoglobulin isotype, including IgG1, IgG2, IgG3 and IgG4. In one embodiment, the human isotype IgG is used.

Fusion compounds comprising an Fc region of an immunoglobulin bestow several desirable properties including increased stability, increased serum half-life (see Capon et al., 1989. Nature 337:525) as well as binding to Fc receptors such as the neonatal Fc receptor (FcRn) (U.S. Pat. Nos. 6,086,875, 6,485,726, 6,030,613; WO 03/077834; US2003-0235536A1), which are incorporated herein by reference in their entireties.

In certain embodiments, the procoagulant compound is linked to one or more truncated Fc regions that are nonetheless sufficient to confer Fc receptor (FcR) binding properties to the Fc region. For example, the portion of an Fc region that binds to FcRn (i.e., the FcRn binding portion) comprises from about amino acids 282-438 of IgG1, EU numbering (with the primary contact sites being amino acids 248, 250-257, 272, 285, 288, 290-291, 308-311, and 314 of the CH2 domain and amino acid residues 385-387, 428, and 433-436 of the CH3 domain. Thus, an Fc region in a fusion compound of the invention may comprise or consist of an FcRn binding partner. FcRn binding partners may be derived from heavy chains of any isotype, including IgG1, IgG2, IgG3 and IgG4. In one embodiment, an FcRn binding partner from an antibody of the human isotype IgG1 is used. In another embodiment, an FcRn binding partner from an antibody of the human isotype IgG4 is used.

In certain embodiments, an Fc region comprises at least one of: a hinge (e.g., upper, middle, and/or lower hinge region) domain (about amino acids 216-230 of an antibody Fc region according to EU numbering), a CH12 domain (about amino acids 231-340 of an antibody Fc region according to EU numbering), a CH3 domain (about amino acids 341-438 of an antibody Fc region according to EU numbering), a CH4 domain, or a variant, portion, or fragment thereof. In other embodiments, an Fc region comprises a complete Fc domain (i.e., a hinge domain, a CH2 domain, and a CH3 domain). In some embodiments, an Fc region comprises, consists essentially of, or consists of a hinge domain (or a portion thereof) fused to a CH3 domain (or a portion thereof), a hinge domain (or a portion thereof) fused to a CH2 domain (or a portion thereof), a CH2 domain (or a portion thereof) fused to a CH3 domain (or a portion thereof), a CH2 domain (or a portion thereof) fused to both a hinge domain (or a portion thereof) and a CH3 domain (or a portion thereof). In still other embodiments, an Fc region lacks at least a portion of a CH2 domain (e.g., all or part of a CH2 domain). In a particular embodiment, an Fc region comprises or consists of amino acids corresponding to EU numbers 221 to 447.

An Fc in a fusion compound of the invention can include, for example, a change (e.g., a substitution) at one or more of the amino acid positions disclosed in Int'l. PCT Publs. WO88/07089A1, WO96/14339A1, WO98/05787A1, WO98/23289A1, WO99/51642A1, WO99/58572A1, WO00/09560A2, WO00/32767A1, WO00/42072A2, WO02/44215A2, WO02/060919A2, WO03/074569A2, WO04/016750A2, WO04/029207A2, WO04/035752A2, WO04/063351A2, WO04/074455A2. WO04/099249A2, WO05/040217A2, WO04/044859, WO05/070963A1, WO05/077981A2, WO05/092925A2, WO05/123780A2, WO06/019447A1, WO06/047350A2, and WO06/085967A2; U.S. Pat. Publ. Nos. US 2007/0231329, US2007/0231329. US2007/0237765, US2007/0237766, US2007/0237767, US2007/0243188, US2007/0248603, US2007/0286859, US2008/0057056; or U.S. Pat. Nos. 5,648,260; 5,739,277; 5,834,250; 5,869,046; 6,096,871; 6,121.022; 6,194,551; 6,242,195; 6,277,375; 6,528,624; 6,538,124; 6,737,056; 6,821,505; 6,998,253; 7,083,784; 7,404,956, and 7,317,091, each of which is incorporated by reference herein in its entirety. In one embodiment, the specific change (e.g., the specific substitution of one or more amino acids disclosed in the art) may be made at one or more of the disclosed amino acid positions. In another embodiment, a different change at one or more of the disclosed amino acid positions (e.g., the different substitution of one or more amino acid position disclosed in the art) may be made.

An Fc region used in the invention may also comprise an art recognized amino acid substitution which alters its glycosylation. For example, the Fc has a mutation leading to reduced glycosylation (e.g., N- or O-linked glycosylation) or may comprise an altered glycoform of the wild-type Fc moiety (e.g., a low fucose or fucose-free glycan).

In some embodiments, the procoagulant compound comprises GSRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 4). In certain embodiments, the fusion compound further comprises a signal peptide, e.g., METDTLLLWV LLLWVPGSTG (SEQ ID NO: 5).

Fusion Compounds Linked to a Heterologous Moiety

In certain embodiments, the fusion compound of the present disclosure is further linked to a heterologous moiety. For example, the procoagulant compound of the present disclosure and/or the immunoglobulin constant region or a portion thereof of the fusion compound can be covalently linked to a heterologous moiety, optionally via a linker.

In one embodiment, a heterologous moiety useful for the invention is a blood coagulation factor and/or platelet targeting moieties. In another embodiment, the blood coagulation factor is selected from FVIIa, FVIII, and FIX. In one example, the procoagulant compound is linked to an internal amino acid residue of the polypeptide (e.g., FVIIa, FVIII, or FIX).

In other embodiments, the heterologous moiety is useful to increase the bioavailability or the in vivo stability/half-life of the compound. Exemplary heterologous moieties include, e.g., known half-life extending moieties, e.g., water-soluble polymers, such as polyethylene glycol (PEG) and polypropylene glycol (PPG), PAS, HES, XTEN, and albumin. In one example, the heterologous moiety is a polymer, e.g., a water-soluble polymer, such as polyethylene glycol (PEG). In another example, the heterologous moiety is a half-life prolonging protein, such as albumin. In another example, the heterologous moiety is a XTEN moiety. In another example, the heterologous moiety is a HES moiety. In another example, the heterologous moiety is a PAS moiety. Other useful heterologous moieties are known in the art and others are further described herein.

Fusion Compounds Linked to FVIII

In various embodiments, the procoagulant compound of the present disclosure and/or the immunoglobulin constant region or a portion thereof (a first immunoglobulin constant region or a portion thereof and/or a second immunoglobulin constant region or a portion thereof) is covalently linked to FVIII or its variant or derivative.

In one example, the fusion compound of the present disclosure includes the procoagulant compound covalently linked to another immunoglobulin constant region or a portion thereof (e.g., Fc) and a FVII-heterologous moiety construct (e.g., FVII-Fc).

The term “FVIII” or “Factor VIII”, as used herein, means functional FVIII protein in its normal role in coagulation, unless otherwise specified (i.e., refers to any FVIII moiety which exhibits biological activity that is associated with native FVIII). Thus, the term FVIII includes FVIII variant proteins that are functional. In some embodiments, FVII proteins are primate (e.g., chimpanzee), human, porcine, canine, and murine FVIII proteins. The full length polypeptide and polynucleotide sequences of FVIII are known, as are many functional fragments, mutants and modified versions. Exemplary FVIII sequences are disclosed, e.g., in WO2011/069164. FVIII polypeptides include, e.g., full-length FVIII, full-length FVIII minus Met at the N-terminus, mature FVIII (minus the signal sequence), mature FVIII with an additional Met at the N-terminus, and/or FVIII with a full or partial deletion of the B domain. In one example, the FVIII is a variant in which the B domain is deleted, either partially or fully. An exemplary sequence of FVIII can be found as NCBI Accession Number NP000123 or UniProtKB/Swiss-Prot entry P00451.

A number of functional FVIII molecules, including B-domain deletions, are disclosed in the following patents: U.S. Pat. No. 6,316,226 and U.S. Pat. No. 6,346,513, both assigned to Baxter; U.S. Pat. No. 7,041,635 assigned to In2Gen; U.S. Pat. No. 5,789,203, U.S. Pat. No. 6,060,447, U.S. Pat. No. 5,595,886, and U.S. Pat. No. 6,228,620 assigned to Chiron; U.S. Pat. No. 5,972,885 and U.S. Pat. No. 6,048,720 assigned to Biovitrum, U.S. Pat. No. 5,543,502 and U.S. Pat. No. 5,610,278 assigned to Novo Nordisk; U.S. Pat. No. 5,171,844 assigned to Immuno Ag; U.S. Pat. No. 5,112,950 assigned to Transgene S.A.; U.S. Pat. No. 4,868,112 assigned to Genetics Institute, each of which is incorporated herein by reference in its entirety.

As used herein, “plasma-derived FVIII” includes all forms of the protein found in blood obtained from a mammal having the property of activating the coagulation pathway.

“B domain” of FVIII, as used herein, is the same as the B domain known in the art that is defined by internal amino acid sequence identity and sites of proteolytic cleavage by thrombin, e.g., residues Ser741-Arg1648 of full length human FVIII. The other human FVIII domains are defined by the following amino acid residues: A1, residues Ala1-Arg372; A2, residues Ser373-Arg740; A3, residues Ser1690-Ile2032; C1, residues Arg2033-Asn2172; C2, residues Ser2173-Tyr2332. The A3-C1-C2 sequence includes residues Ser1690-Tyr2332. The remaining sequence, residues Glu1649-Arg1689, is usually referred to as the FVIII light chain activation peptide. The locations of the boundaries for all of the domains, including the B domains, for porcine, mouse and canine FVIII are also known in the art. Preferably, the B domain of FVIII is deleted (“B domain deleted FVIII” or “BDD FVII”). An example of a BDD FVIII is REFACTO® (recombinant BDD FVIII).

A “B domain deleted FVIII” may have the full or partial deletions disclosed in U.S. Pat. Nos. 6,316,226, 6,346,513, 7,041,635, 5,789,203, 6,060,447, 5,595,886, 6,228,620, 5,972,885, 6,048,720, 5,543,502, 5,610,278, 5,171,844, 5,112,950, 4,868,112, and 6,458,563, each of which is incorporated herein by reference in its entirety. In some embodiments, a BDD FVIII sequence of the present invention comprises any one of the deletions disclosed at col. 4, line 4 to col. 5, line 28 and examples 1-5 of U.S. Pat. No. 6,316,226 (also in U.S. Pat. No. 6,346,513). In some embodiments, a BDD FVIII of the present invention has a deletion disclosed at col. 2, lines 26-51 and examples 5-8 of U.S. Pat. No. 5,789,203 (also U.S. Pat. No. 6,060,447, U.S. Pat. No. 5,595,886, and U.S. Pat. No. 6,228,620). In some embodiments, a BDD FVIII has a deletion described in col. 1, lines 25 to col. 2, line 40 of U.S. Pat. No. 5,972,885; col. 6, lines 1-22 and example 1 of U.S. Pat. No. 6,048,720; col. 2, lines 17-46 of U.S. Pat. No. 5,543,502; col. 4, line 22 to col. 5, line 36 of U.S. Pat. No. 5,171,844; col. 2, lines 55-68, FIG. 2, and example 1 of U.S. Pat. No. 5,112,950; col. 2, line 2 to col. 19, line 21 and table 2 of U.S. Pat. No. 4,868,112; col. 2, line 1 to col. 3, line 19, col. 3, line 40 to col. 4, line 67, col. 7, line 43 to col. 8, line 26, and col. 11, line 5 to col. 13, line 39 of U.S. Pat. No. 7,041,635; or col. 4, lines 25-53, of U.S. Pat. No. 6,458,563. In some embodiments, a BDD FVIII has a deletion of most of the B domain, but still contains amino-terminal sequences of the B domain that are essential for in vivo proteolytic processing of the primary translation product into two polypeptide chain, as disclosed in WO 91/09122, which is incorporated herein by reference in its entirety. In some embodiments, a BDD FVIII is constructed with a deletion of amino acids 747-1638, i.e., virtually a complete deletion of the B domain. Hoeben R. C., et al. J. Biol. Chem. 265 (13): 7318-7323 (1990), incorporated herein by reference in its entirety. A BDD FVIII may also contain a deletion of amino acids 771-1666 or amino acids 868-1562 of FVIII. Meulien P., et al. Protein Eng. 2(4): 301-6 (1988), incorporated herein by reference in its entirety. Additional B domain deletions that are part of the invention include, e.g.: deletion of amino acids 982 through 1562 or 760 through 1639 (Toole et al., Proc. Natl. Acad. Sci. U.S.A. (1986) 83, 5939-5942)), 797 through 1562 (Eaton, et al. Biochemistry (1986) 25:8343-8347)), 741 through 1646 (Kaufman (PCT published application No. WO 87/04187)), 747-1560 (Sarver, et al., DNA (1987) 6:553-564)), 741 through 1648 (Pasek (PCT application No. 88/00831)), 816 through 1598 or 741 through 1689 (Lagner (Behring Inst. Mitt. (1988) No 82:16-25, EP 295597)), each of which is incorporated herein by reference in its entirety. Each of the foregoing deletions may be made in any FVIII sequence.

In one example, the FVIII polypeptide is a single-chain FVIII. In some embodiments, the FVIII has an increased half-life (t1/2) due to linkage to a heterologous moiety that is a half-life extending moiety.

Functional FVIII variants are known, as is discussed herein. In addition, hundreds of nonfunctional mutations in FVIII have been identified in hemophilia patients, and it has been determined that the effect of these mutations on FVIII function is due more to where they lie within the 3-dimensional structure of FVIII than on the nature of the substitution (Cutler et al., Hum. Mutat. 19:274-8 (2002)), incorporated herein by reference in its entirety. In addition, comparisons between FVIII from humans and other species have identified conserved residues that are likely to be required for function (Cameron et al., Thromb. Haemost. 79:317-22 (1998); U.S. Pat. No. 6,251,632), incorporated herein by reference in its entirety.

The human FVIII gene was isolated and expressed in mammalian cells (Toole, J. J., et al., Nature 312:342-347 (1984); Gitschier, J., et al., Nature 312:326-330 (1984); Wood, W. I., et al., Nature 312:330-337 (1984); Vehar, G. A., et al., Nature 312:337-342 (1984); WO 87/04187; WO 88/08035; WO 88/03558; U.S. Pat. No. 4,757,006), each of which is incorporated herein by reference in its entirety, and the amino acid sequence was deduced from cDNA. Capon et al., U.S. Pat. No. 4,965,199, incorporated herein by reference in its entirety, disclose a recombinant DNA method for producing FVIII in mammalian host cells and purification of human FVIII. Human FVIII expression in CHO (Chinese hamster ovary) cells and BHKC (baby hamster kidney cells) has been reported. Human FVIII has been modified to delete part or all of the B domain (U.S. Pat. Nos. 4,994,371 and 4,868,112, each of which is incorporated herein by reference in its entirety), and replacement of the human FVIII B domain with the human factor V B domain has been performed (U.S. Pat. No. 5,004,803, incorporated herein by reference in its entirety). The cDNA sequence encoding human FVIII and predicted amino acid sequence are shown in SEQ ID NOs:1 and 2, respectively, of US Application Publ. No. 2005/0100990, incorporated herein by reference in its entirety.

U.S. Pat. No. 5,859,204, Lollar, J. S., incorporated herein by reference in its entirety, reports functional mutants of FVIII having reduced antigenicity and reduced immunoreactivity. U.S. Pat. No. 6,376,463, Lollar, J. S., incorporated herein by reference in its entirety, also reports mutants of FVIII having reduced immunoreactivity. US Application Publ. No. 2005/0100990, Saenko et al., incorporated herein by reference in its entirety, reports functional mutations in the A2 domain of FVIII.

The porcine FVIII sequence is published, (Toole, J. J., et al., Proc. Natl. Acad. Sci. USA 83:5939-5942 (1986)), incorporated herein by reference in its entirety, and the complete porcine cDNA sequence obtained from PCR amplification of FVIII sequences from a pig spleen cDNA library has been reported (Healey, J. F., et al., Blood 88:4209-4214 (1996), incorporated herein by reference in its entirety). Hybrid human/porcine FVIII having substitutions of all domains, all subunits, and specific amino acid sequences were disclosed in U.S. Pat. No. 5,364,771 by Lollar and Runge, and in WO 93/20093, incorporated herein by reference in its entirety. More recently, the nucleotide and corresponding amino acid sequences of the A1 and A2 domains of porcine FVIII and a chimeric FVIII with porcine A1 and/or A2 domains substituted for the corresponding human domains were reported in WO 94/11503, incorporated herein by reference in its entirety. U.S. Pat. No. 5,859,204, Lollar, J. S., also discloses the porcine cDNA and deduced amino acid sequences. U.S. Pat. No. 6,458,563, incorporated herein by reference in its entirety assigned to Emory discloses a B-domain deleted porcine FVIII.

In one example, a fusion compound comprises the procoagulant compound linked to a first Fc and FVIII linked to a second Fc. Exemplary FVIII and FVIII-Fc polypeptides useful for the invention include, e.g., SEQ ID NOs: 12 and 14 or a portion thereof.

The FVIII may be at least 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to a portion of the FVIII amino acid sequence of SEQ ID NOs: 12 or 14 without a signal sequence (e.g., amino acids 20 to 1457 of SEQ ID NO: 12; amino acids 20 to 2351 of SEQ ID NO: 14).

The FVIII may be at least 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% identical to a portion of the FVIII amino acid sequence of SEQ ID NOs: 12 or 14 with a signal sequence (e.g., amino acids 1 to 1457 of SEQ ID NO: 12; amino acids 1 to 2351 of SEQ ID NO: 14).

The polynucleotide variants may contain alterations in the coding regions, non-coding regions, or both. Especially preferred are polynucleotide variants containing alterations which produce silent substitutions, additions, or deletions, but do not alter the properties or activities of the encoded polypeptide. Nucleotide variants produced by silent substitutions due to the degeneracy of the genetic code are preferred. Moreover, variants in which 5-10, 1-5, or 1-2 amino acids are substituted, deleted, or added in any combination are also preferred. Polynucleotide variants can be produced for a variety of reasons, e.g., to optimize codon expression for a particular host (change codons in the human mRNA to those preferred by a bacterial host such as E. coli).

In one example, the FVIII of the present disclosure is a polypeptide having FVIII-like activity, but does not have the amino acid sequence of FVIII. For example, the polypeptide having FVIII-like activity increases the catalytic activity of FIXa. In one example, the polypeptide having FVIII-like activity is an antibody (e.g., FIX/FIXa activating antibodies and antibody derivatives). Exemplary polypeptides having FVIII-like activity are disclosed in U.S. Pat. No. 7,033,590, which is incorporated herein by reference in its entirety.

Methods for the preparation of recombinant FVIII or FVIII-Fc constructs are disclosed, e.g., in WO2011/069164, which is incorporated herein by reference in its entirety.

Fusion Compounds Linked to FVII

In various embodiments, the procoagulant compound of the present disclosure and/or the immunoglobulin constant region or a portion thereof (a first immunoglobulin constant region or a portion thereof and/or a second immunoglobulin constant region or a portion thereof) is covalently linked to FVIIa or a variant or derivative thereof.

In one example, the fusion compound of the present disclosure includes the procoagulant compound covalently linked to an immunoglobulin constant region or a portion thereof (e.g., Fc) and a FVIIa-heterologous moiety construct (e.g., FVIIa-Fc).

The term “Factor VII” or “FVII”, includes “Factor VIIa”, or “FVIIa”, and herein, means functional FVII protein or functional FVIIa protein in its normal role in coagulation, unless otherwise specified (i.e., refers to any FVII moiety which exhibits biological activity that is associated with native FVII). Thus, the term FVII includes variant proteins that are functional. FVII proteins can be primate (e.g., chimpanzee), human, porcine, canine, and murine FVII proteins. The full length polypeptide and polynucleotide sequences of FVII are known, as are many functional fragments, mutants and modified versions. Exemplary chimeric and hybrid FVII sequences are disclosed, e.g., in US 2009/0291890 A1, US2009/0041744 A1, and US 2008/0318276 A1. Factor VII polypeptides include, e.g., full-length FVII, full-length FVII minus Met at the N-terminus, mature FVII (minus the signal sequence), and mature FVII with an additional Met at the N-terminus. An exemplary sequence of FVII can be found as NCBI Accession Number NP000122.

As used herein, “plasma-derived FVII” includes all forms of the protein found in blood obtained from a mammal having the property of activating the coagulation pathway.

Examples of human FVII amino acid and DNA sequences are shown as subsequences in SEQ ID NO: 16 and SEQ ID NO: 15. FVII polypeptides include, e.g., full-length FVII, full-length FVII minus Met at the N-terminus, mature FVII (minus the signal sequence), and/or mature FVII with an additional Met at the N-terminus.

The term “activated Factor VII” or “FVIIa” refers to the enzymatically active two-chain form of circulating FVII generated as well as variants thereof in case coagulation activity (e.g., thrombin generation) is needed. The two-chain Factor VIIa is a polypeptide produced from FVII by hydrolysis of the Arg152-Ile153 peptide bond of FVII. FVIIa also comprises 406 amino acid residues, 10 of which are γ-carboxylated glutamic acid residues, N-glycosylated asparagines residues (no 145 and no 322), and O-glycosylated serine residues in position 52 and 60. The variant forms of FVIIa encompasses i.a. molecules wherein one or more amino acid residues have been substituted, added or deleted, molecules with different number of GLA residues, molecules with a modified or incomplete glycosylation pattern. The terms “FVII” and “activated FVII” include naturally occurring FVII and activated FVII but also encompass function conservative variants and modified forms thereof.

The term “Factor VIIa” or “FVIIa” includes activatable FVII.

Exemplary FVII sequences are disclosed herein. For example, the FVII may be at least 90% or 95% identical to a FVII amino acid sequence without a signal sequence (e.g., amino acids 61 to 466 of SEQ ID NO: 16). The FVII may be identical to a Factor VII amino acid sequence without a signal sequence (e.g., amino acids 61 to 466 of SEQ ID NO:16).

Exemplary FVII-Fc amino acid and DNA sequences are represented by SEQ ID NO:16 and 15. The FVII-Fc may comprise a sequence at least 90% or 95% identical to the FVII and Fc amino acid sequence without a signal sequence (e.g., amino acids 61 to 693 of SEQ ID NO:16) or at least 90% or 95% identical to the FVII and Fc amino acid sequence with a signal sequence (e.g., amino acids 1 to 693 of SEQ ID NO: 16).

The FVII-Fc may comprise a sequence identical to the FVII and Fc amino acid sequence without a signal sequence (e.g., amino acids 61 to 693 of SEQ ID NO:16) or identical to the FVII and Fc amino acid sequence with a signal sequence (e.g., amino acids 1 to 693 of SEQ ID NO:16).

FVII polynucleotides include, e.g., those of SEQ ID NO:15 and fragments thereof, e.g., those that encode the FVII fragment.

The term “Factor VIIa derivative” or “FVIIa derivative” as used herein, is intended to designate a FVIIa polypeptide exhibiting substantially the same or improved biological activity relative to wild-type Factor VIIa, in which one or more of the amino acids of the parent peptide have been genetically and/or chemically and/or enzymatically modified, e.g. by alkylation, glycosylation, deglycosylation, PEGylation, acylation, ester formation or amide formation or the like.

The term “improved biological activity” refers to FVIIa polypeptides with i) substantially the same or increased proteolytic activity compared to recombinant wild type human Factor VIIa or ii) to FVIIa polypeptides with substantially the same or increased TF binding activity compared to recombinant wild type human Factor VIIa or iii) to FVIIa polypeptides with substantially the same or increased half life in blood plasma compared to recombinant wild type human Factor VIIa.

Using known methods of protein engineering and recombinant DNA technology, variants may be generated to improve or alter the characteristics of the polypeptides. For instance, one or more amino acids can be deleted from the N-terminus or C-terminus of the secreted protein without substantial loss of biological function. The authors of Ron et al., J. Biol. Chem. 268: 2984-2988 (1993), incorporated herein by reference in its entirety, reported variant KGF proteins having heparin binding activity even after deleting 3, 8, or 27 amino-terminal amino acid residues. Similarly, Interferon gamma exhibited up to ten times higher activity after deleting 8-10 amino acid residues from the carboxy terminus of this protein. (Dobeli et al., J. Biotechnology 7:199-216 (1988), incorporated herein by reference in its entirety.)

As stated above, polypeptide variants include, e.g., modified polypeptides. Modifications include, e.g., acetylation, acylation, ADP-ribosylation, amidation, covalent attachment of flavin, covalent attachment of a heme moiety, covalent attachment of a nucleotide or nucleotide derivative, covalent attachment of a lipid or lipid derivative, covalent attachment of phosphotidylinositol, cross-linking, cyclization, disulfide bond formation, demethylation, formation of covalent cross-links, formation of cysteine, formation of pyroglutamate, formylation, gamma-carboxylation, glycosylation, GPI anchor formation, hydroxylation, iodination, methylation, myristoylation, oxidation, pegylation (Mei et al., Blood 116:270-79 (2010), which is incorporated herein by reference in its entirety), proteolytic processing, phosphorylation, prenylation, racemization, selenoylation, sulfation, transfer-RNA mediated addition of amino acids to proteins such as arginylation, and ubiquitination. In some embodiments, FVII is modified, e.g., pegylated, at any convenient location. In some embodiments, FVII is pegylated at a surface exposed amino acid of Factor VII, preferably a surface exposed.

Fusion Compounds Linked to FIX

In various embodiments, the procoagulant compound of the present disclosure and/or the immunoglobulin constant region or a portion thereof (a first immunoglobulin constant region or a portion thereof and/or a second immunoglobulin constant region or a portion thereof) is covalently linked to FIX or a variant or derivative thereof.

In one example, the fusion compound of the present disclosure includes the procoagulant compound covalently linked to an immunoglobulin constant region or a portion thereof (e.g., Fc) and a FIX-heterologous moiety construct (e.g., FIX-Fc).

“Factor IX” or “FIX,” as used herein, means functional Factor IX polypeptide in its normal role in coagulation, unless otherwise specified. Thus, the term Factor IX includes FIX variant polypeptides that are functional and the polynucleotides that encode such functional variant polypeptides. Factor IX polypeptides can be the human, bovine, porcine, canine, feline, and murine Factor IX polypeptides. The full length polypeptide and polynucleotide sequences of Factor IX are known, as are many functional variants, e.g., fragments, mutants and modified versions. Factor IX polypeptides include full-length Factor IX, full-length Factor IX minus Met at the N-terminus, mature Factor IX (minus the signal sequence), and mature Factor IX with an additional Met at the N-terminus.

The FIX may be at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to a FIX amino acid sequence without a signal sequence (e.g., amino acids 47 to 461 of SEQ ID NO:8). The FIX may be identical to a FIX amino acid sequence without a signal sequence (e.g., amino acids 47 to 461 of SEQ ID NO:8).

The FIX may be at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to a FIX amino acid sequence with a signal sequence (e.g., amino acids 1 to 461 of SEQ ID NO:8). The FIX may be identical to a FIX amino acid sequence with a signal sequence (e.g., amino acids 1 to 461 of SEQ ID NO:8).

In one example, FIX is linked to Fc. Exemplary FIX-Fc amino acid and DNA sequences include SEQ ID NOs:7 and 8, with or without its signal sequence.

The FIX-Fc polypeptide may comprise a sequence at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to the FIX and Fc amino acid sequences without a signal sequence (amino acids 47 to 688 of SEQ ID NO:8) or at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to the Factor IX and Fc amino acid sequence with a signal sequence (amino acids 1 to 688 of SEQ ID NO:8).

The FIX-Fc polypeptide may comprise a sequence identical to the Factor IX and Fc amino acid sequence without a signal sequence (amino acids 47 to 688 of SEQ ID NO:8) or identical to the Factor IX and Fc amino acid sequence with a signal sequence (amino acids 1 to 688 of SEQ ID NO:8).

A great many functional FIX variants are known. International publication number WO 02/040544 A3, which is herein incorporated by reference in its entirety, discloses mutants that exhibit increased resistance to inhibition by heparin at page 4, lines 9-30 and page 15, lines 6-31. International publication number WO 03/020764 A2, which is herein incorporated by reference in its entirety, discloses Factor IX mutants with reduced T cell immunogenicity in Tables 2 and 3 (on pages 14-24), and at page 12, lines 1-27. International publication number WO 2007/149406 A2, which is herein incorporated by reference in its entirety, discloses functional mutant Factor IX molecules that exhibit increased protein stability, increased in vivo and in vitro half life, and increased resistance to proteases at page 4, line 1 to page 19, line 11. WO 2007/149406 A2 also discloses chimeric and other variant Factor IX molecules at page 19, line 12 to page 20, line 9. International publication number WO 08/118507 A2, which is herein incorporated by reference in its entirety, discloses Factor IX mutants that exhibit increased clotting activity at page 5, line 14 to page 6, line 5. International publication number WO 09/051717 A2, which is herein incorporated by reference in its entirety, discloses Factor IX mutants having an increased number of N-linked and/or O-linked glycosylation sites, which results in an increased half life and/or recovery at page 9, line 11 to page 20, line 2. International publication number WO 09/137254 A2, which is herein incorporated by reference in its entirety, also discloses Factor IX mutants with increased numbers of glycosylation sites at page 2, paragraph [006] to page 5, paragraph [011] and page 16, paragraph [044] to page 24, paragraph [057]. International publication number WO 09/130198 A2, which is herein incorporated by reference in its entirety, discloses functional mutant Factor IX molecules that have an increased number of glycosylation sites, which result in an increased half life, at page 4, line 26 to page 12, line 6. International publication number WO 09/140015 A2, which is herein incorporated by reference in its entirety, discloses functional Factor IX mutants that an increased number of Cys residues, which may be used for polymer (e.g., PEG) conjugation, at page 11, paragraph [0043] to page 13, paragraph [0053].

In addition, hundreds of non-functional mutations in Factor IX have been identified in hemophilia patients, many of which are disclosed in Table 1, at pages 11-14 of International publication number WO 09/137254 A2, which is herein incorporated by reference in its entirety. Such non-functional mutations are not included in the invention, but provide additional guidance for which mutations are more or less likely to result in a functional Factor IX polypeptide.

Variant FIX polynucleotides may comprise, or alternatively consist of, a nucleotide sequence which is at least 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to, for example, the nucleotide coding sequence in SEQ ID NO: 7 (the Factor IX portion, the Fc portion, individually or together) or the complementary strand thereto, the nucleotide coding sequence of known mutant and recombinant Factor IX or Fc such as those disclosed in the publications and patents cited herein or the complementary strand thereto, a nucleotide sequence encoding the polypeptide of SEQ ID NO: 8 (the Factor IX portion, the Fc portion, individually or together), and/or polynucleotide fragments of any of these nucleic acid molecules (e.g., those fragments described herein). Polynucleotides which hybridize to these nucleic acid molecules under stringent hybridization conditions or lower stringency conditions are also included as variants, as are polypeptides encoded by these polynucleotides as long as they are functional.

Variant FIX polypeptides may comprise, or alternatively consist of, an amino acid sequence which is at least 85%, 90%, 95%, 96%, 97%, 98%, 99% identical to, for example, the polypeptide sequence shown in SEQ ID NO: 8 (the Factor IX portion, the Fc portion, individually or together), and/or polypeptide fragments of any of these polypeptides (e.g., those fragments described herein).

Fusion Compounds Linked to Platelet-Targeting Moiety (PTM)

In various embodiments, the procoagulant compound of the present disclosure is covalently linked to a PTM (e.g., PDG-13) or a PTM-heterologous moiety construct. In various embodiments the procoagulant compound of the present disclosure is covalently linked to a platelet targeting moiety.

Linking the fusion compound of the present disclosure to a platelet targeting moiety can be useful for targeting the fusion to the surface of platelets (e.g., in vivo). In one example, the fusion compound comprising the procoagulant compound is targeted to platelets in order to enhance its efficacy by localizing the procoagulant compound to the site of coagulation using a “targeting moiety” which binds to a molecule expressed on platelets. In addition to increasing the local concentration through the PTM, the concomitant interaction of the procoagulant compound with FIXa may stabilize FIX association with the Xase complex on platelet surfaces, similar to the mechanism of action of FVIIIa. The targeted molecules cannot be expressed on cells or tissues other than platelets, i.e., the targeting moieties specifically bind to platelets. Linking the procoagulant compound or an immunoglobulin constant region or a portion thereof to the targeting moiety may enhance its biological activity. This strategy may reduce the procoagulant compound dose necessary to obtain a desired pharmaceutical effect, and thus can reduce potential side effects that the compound may have. Accordingly, in one example, the fusion compound of the present disclosure bind (e.g., specifically) to platelets.

In one example, the targeting moiety binds to receptors/conformations found on resting platelets. By doing so, sites for coagulation could be primed for enhanced efficacy. Targeting such molecule may also extend half life of the compound and/or prevent clearance. Exemplary platelet targeting moieties according to this embodiment include GpIb (e.g., GpIbalpha) of the GpIbN/IX complex, GpVI, and nonactive forms of GPIIb/IIIa.

In another example, the platelet targeting moiety binds to receptors/conformations only found on activated platelets in order to localize the procoagulant compound to a site of active coagulation. Exemplary such molecules include the active form of GpIIb/IIIa as well as CD62P.

In another embodiment, the platelet targeting moiety selectively binds to a target selected from the group consisting of: P selectin, GMP-33, LAMP-1, LAMP-2, CD40L, and LOX-1.

The platelet targeting moiety can be, e.g., MB9, SCE5, scFv, AP3, or peptides (e.g., “RGD” peptides) targeting GPIIb/IIIa, a fatty acid or small molecule capable of inserting into plasma membranes, OS1, OS2, and PS4 targeting GP1b. In one embodiment, the platelet targeting moiety is OS1, OS2 and PS4 targeting GP1b.

In another embodiment, the platelet targeting moiety is a moiety that binds to GPIIb/IIa (e.g., PDG-13).

In one example, the fusion compound of the present disclosure includes a platelet targeting moiety-heterologous moiety construct (e.g., PTM-Fc) and the procoagulant compound covalently linked to an immunoglobulin constant region or a portion thereof (e.g., Fc).

In one embodiment, the platelet targeting moiety comprises at least one of an antigen binding site (e.g., an antigen binding site of an antibody, antibody variant, or antibody fragment), a polypeptide, a receptor binding portion of ligand, or a ligand binding portion of a receptor which specifically binds to platelets, e.g., resting or activated platelets. Exemplary targeting moieties include scFv molecules or peptides which bind to molecules to be targeted. In one embodiment, the targeting moiety binds to resting platelets. In one embodiment, the targeting moiety selectively binds to activated platelets.

In one embodiment, the targeting moiety selectively binds to a target selected from the group consisting of: GPIba, GPVI, and the nonactive form of GPIIb/IIIa. In another embodiment, the targeting moiety selectively binds to a target selected from the group consisting of: GPIIb/IIIa, P selectin, GMP-33, LAMP-1, LAMP-2, CD40L, and LOX-1. Examples of platelet targeting moieties are described below.

Antigen Binding Sites

In certain embodiments, the platelet targeting moiety is an antigen binding portion (e.g., binding site) of an antibody. In one embodiment, the antigen binding portion targets the composition to platelets

In other embodiments, a binding site of a polypeptide of the invention may comprise an antigen binding fragment. The term “antigen-binding portion” refers to a polypeptide fragment of an immunoglobulin, antibody, or antibody variant which binds antigen or competes with intact antibody (i.e., with the intact antibody from which they were derived) for antigen binding (i.e., specific binding). For example, said antigen binding fragments can be derived from any of the antibodies or antibody variants described supra. Antigen binding portions can be produced by recombinant or biochemical methods that are well known in the art. Exemplary antigen-binding fragments include Fv, Fab, Fab′, and (Fab′)₂ as well as scFv molecules.

In other embodiments, the targeting moiety is a binding site from a single chain binding molecule (e.g., a single chain variable region or scFv). Techniques described for the production of single chain antibodies (U.S. Pat. No. 4,694,778; Bird, Science 242:423-442 (1988); Huston et al., Proc. Natl. Acad. Sci. USA 85:5879-5883 (1988); and Ward et al., Nature 334:544-554 (1989)) can be adapted to produce single chain binding molecules. Single chain antibodies are formed by linking the heavy and light chain fragments of the Fv region via an amino acid bridge, resulting in a single chain antibody. Techniques for the assembly of functional Fv fragments in E. coli may also be used (Skerra et al., Science 242:1038-1041 (1988)).

In certain embodiments, the platelet targeting moiety includes one or more binding sites or regions comprising or consisting of a single chain variable region sequence (scFv). Single chain variable region sequences comprise a single polypeptide having one or more antigen binding sites, e.g., a V_(L) domain linked by a flexible linker to a V_(H) domain. The VL and/or VH domains may be derived from any of the antibodies or antibody variants described supra. ScFv molecules can be constructed in a V_(H)-linker-V_(L) orientation or V_(L)-linker-V_(H) orientation. The flexible linker that links the V_(L) and V_(H) domains that make up the antigen binding site preferably comprises from about 10 to about 50 amino acid residues. In one embodiment, the polypeptide linker is a gly-ser polypeptide linker. An exemplary gly/ser polypeptide linker is of the formula (Gly4Ser)n (SEQ ID NO: 24), wherein n is a positive integer (e.g., 1, 2, 3, 4, 5, or 6). Other polypeptide linkers are known in the art. Antibodies having single chain variable region sequences (e.g. single chain Fv antibodies) and methods of making said single chain antibodies are well-known in the art (see e.g., Ho et al. 1989. Gene 77:51; Bird et al. 1988 Science 242:423; Pantoliano et al. 1991. Biochemistry 30:10117; Milenic et al. 1991. Cancer Research 51:6363; Takkinen et al. 1991. Protein Engineering 4:837).

In certain embodiments, a scFv molecule is a stabilized scFv molecule. In one embodiment, the stabilized scFv molecule may comprise a scFv linker interposed between a V_(H) domain and a V_(L) domain, wherein the V_(H) and V_(L) domains are linked by a disulfide bond between an amino acid in the V_(H) and an amino acid in the V₁ domain. In other embodiments, the stabilized scFv molecule may comprise a scFv linker having an optimized length or composition. In yet other embodiments, the stabilized scFv molecule may comprise a V_(H) or V_(L) domain having at least one stabilizing amino acid substitution(s). In yet another embodiment, a stabilized scFv molecule may have at least two of the above listed stabilizing features.

Stabilized scFv molecules have improved protein stability or impart improved protein stability to the polypeptide to which it is operably linked. Preferred scFv linkers of the invention improve the thermal stability of a polypeptide of the invention by at least about 2° C. or 3° C. as compared to a conventional polypeptide Comparisons can be made, for example, between the scFv molecules of the invention. In certain embodiments, the stabilized scFv molecule comprises a (Gly₄Ser)₄ (SEQ ID NO: 23) scFv linker and a disulfide bond which links V_(H) amino acid 44 and V_(L) amino acid 100. Other exemplary stabilized scFv molecules which may be employed in the polypeptides of the invention are described in U.S. patent application Ser. No. 11/725,970, filed on Mar. 19, 2007, incorporated herein by reference in its entirety.

In one example, the platelet targeting moiety includes a variable region or portion thereof (e.g. a VL and/or VH domain) derived from an antibody using art recognized protocols. For example, the variable domain may be derived from antibody produced in a non-human mammal, e.g., murine, guinea pig, primate, rabbit or rat, by immunizing the mammal with the antigen or a fragment thereof. See Harlow & Lane, supra, incorporated by reference for all purposes. The immunoglobulin may be generated by multiple subcutaneous or intraperitoneal injections of the relevant antigen (e.g., purified tumor associated antigens or cells or cellular extracts comprising such antigens) and an adjuvant. This immunization typically elicits an immune response that comprises production of antigen-reactive antibodies from activated splenocytes or lymphocytes.

Optionally, antibodies may be screened for binding to platelets of a specific activation state or to a specific region or desired fragment of the antigen without binding to other nonoverlapping fragments of the antigen. The latter screening can be accomplished by determining binding of an antibody to a collection of deletion mutants of the antigen and determining which deletion mutants bind to the antibody. Binding can be assessed, for example, by Western blot or ELISA. The smallest fragment to show specific binding to the antibody defines the epitope of the antibody. Alternatively, epitope specificity can be determined by a competition assay is which a test and reference antibody compete for binding to the antigen. If the test and reference antibodies compete, then they bind to the same epitope or epitopes sufficiently proximal such that binding of one antibody interferes with binding of the other.

In other embodiments, the binding site is derived from a fully human antibody. Human or substantially human antibodies may be generated in transgenic animals (e.g., mice) that are incapable of endogenous immunoglobulin production (see e.g., U.S. Pat. Nos. 6,075,181, 5,939,598, 5,591,669 and 5,589,369, each of which is incorporated herein by reference). Another means of generating human antibodies using SCID mice is disclosed in U.S. Pat. No. 5,811,524 which is incorporated herein by reference. It will be appreciated that the genetic material associated with these human antibodies may also be isolated and manipulated as described herein.

Yet another highly efficient means for generating recombinant antibodies is disclosed by Newman, Biotechnology, 10: 1455-1460 (1992). Specifically, this technique results in the generation of primatized antibodies that contain monkey variable domains and human constant sequences. This reference is incorporated by reference in its entirety herein. Moreover, this technique is also described in commonly assigned U.S. Pat. Nos. 5,658,570, 5,693,780 and 5,756,096 each of which is incorporated herein by reference.

In another embodiment, a variable region domain of an altered antibody of the invention consists of a V_(H) domain, e.g., derived from camelids, which is stable in the absence of a V_(L) chain (Hamers-Castennan et al. (1993). Nature, 363:446; Desmyter et al. (1996). Nat. Struct. Biol. 3: 803; Decanniere et al. (1999). Structure, 7:361; Davies et al. (1996). Protein Eng., 9:531; Kortt et al. (1995). J. Protein Chem., 14:167).

Further, the platelet targeting moiety may comprise a variable domain or CDR derived from a fully murine, fully human, chimeric, humanized, non-human primate or primatized antibody. Non-human antibodies, or fragments or domains thereof, can be altered to reduce their immunogenicity using art recognized techniques.

In one embodiment, the variable domains are altered by at least partial replacement of one or more CDRs. In another embodiment, variable domains can optionally be altered, e.g., by partial framework region replacement and sequence changing. In making a humanized variable region the CDRs may be derived from an antibody of the same class or even subclass as the antibody from which the framework regions are derived, however, it is envisaged that the CDRs will be derived from an antibody of different class and from an antibody from a different species. It may not be necessary to replace all of the CDRs with the complete CDRs from the donor variable region to transfer the antigen binding capacity of one variable domain to another. Rather, it may only be necessary to transfer those residues that are necessary to maintain the activity of the binding domain. Given the explanations set forth in U.S. Pat. Nos. 5,585,089, 5,693,761 and 5,693,762, it will be well within the competence of those skilled in the art, either by carrying out routine experimentation or by trial and error testing to obtain a functional antigen binding site with reduced immunogenicity.

In other aspects, the polypeptides of the invention may comprise antigen binding sites, or portions thereof, derived from modified forms of antibodies. Exemplary such forms include, e.g., minibodies, diabodies, triabodies, nanobodies, camelids, Dabs, tetravalent antibodies, intradiabodies (e.g., Jendreyko et al. 2003. J. Biol. Chem. 278:47813), fusion compounds (e.g., antibody cytokine fusion compounds, proteins fused to at least a portion of an Fc receptor), and bispecific antibodies. Other modified antibodies are described, for example in U.S. Pat. No. 4,745,055; EP 256,654; Faulkner et al., Nature 298:286 (1982); EP 120,694; EP 125,023; Morrison, J. Immun. 123:793 (1979); Kohler et al., Proc. Natl. Acad. Sci. USA 77:2197 (1980); Raso et al., Cancer Res. 41:2073 (1981); Morrison et al., Ann. Rev. Immunol. 2:239 (1984); Morrison, Science 229:1202 (1985); Morrison et al., Proc. Natl. Acad. Sci. USA 81:6851 (1984); EP 255,694; EP 266,663; and WO 88/03559. Reassorted immunoglobulin chains also are known. See, for example, U.S. Pat. No. 4,444,878; WO 88/03565; and EP 68,763 and references cited therein.

In another embodiment, the platelet targeting moiety includes an antigen binding site or region which is a diabody or an antigen binding site derived therefrom. Diabodies are dimeric, tetravalent molecules each having a polypeptide similar to scFv molecules, but usually having a short (e.g., less than 10 and preferably 1-5) amino acid residue linker connecting both variable domains, such that the V_(L) and V_(H) domains on the same polypeptide chain cannot interact. Instead, the V_(L) and V_(H) domain of one polypeptide chain interact with the V_(H) and V_(L) domain (respectively) on a second polypeptide chain (see, for example, WO 02/02781). In one embodiment, an immature polypeptide of the invention comprises a diabody which is operably linked to the N-terminus and/or C-terminus of at least one genetically-fused Fc region (i.e., scFc region).

Exemplary single-domain antibodies employed in the binding molecules of the invention include, for example, the Camelid heavy chain variable domain (about 118 to 136 amino acid residues) as described in Hamers-Casterman, et al., Nature 363:446-448 (1993), and Dumoulin, et al., Protein Science 11:500-515 (2002). Other exemplary single domain antibodies include single VH or VL domains, also known as DABS® (Domantis Ltd., Cambridge, UK). Yet other single domain antibodies include shark antibodies (e.g., shark Ig-NARs). Shark Ig-NARs comprise a homodimer of one variable domain (V-NAR) and five C-like constant domains (C-NAR), wherein diversity is concentrated in an elongated CDR3 region varying from 5 to 23 residues in length. In camelid species (e.g., llamas), the heavy chain variable region, referred to as VHH, forms the entire antigen-binding domain. Methods for making single domain binding molecules are described in U.S. Pat. Nos. 6,005,079 and 6,765,087, both of which are incorporated herein by reference. Exemplary single domain antibodies comprising VHH domains include NANOBODIES® (Ablynx NV, Ghent, Belgium).

Exemplary antibodies from which binding sites can be derived for use in the binding molecules of the invention are known in the art. Antibodies known to bind to platelets can be used to derive binding sites, for example, the MB9 antibody described in US 2007/0218067 or the variable region or an scFv molecule comprising the variable region can be used as a targeting moiety in a construct of the invention.

Non-Immunoglobulin Platelet Binding Molecules

In certain other embodiments, the targeting moiety comprise one or more binding sites derived from a non-immunoglobulin binding molecule. As used herein, the term “non-immunoglobulin binding molecules” are binding molecules whose binding sites comprise a portion (e.g., a scaffold or framework) which is derived from a polypeptide other than an immunoglobulin, but which may be engineered (e.g., mutagenized) to confer a desired binding specificity.

Other examples of binding molecules comprising binding sites not derived from antibody molecules include receptor binding sites and ligand binding sites which bind to platelets.

Non-immunoglobulin binding molecules may be identified by selection or isolation of a target-binding variant from a library of binding molecules having artificially diversified binding sites. Diversified libraries can be generated using completely random approaches (e.g., error-prone PCR, exon shuffling, or directed evolution) or aided by art-recognized design strategies. For example, amino acid positions that are usually involved when the binding site interacts with its cognate target molecule can be randomized by insertion of degenerate codons, trinucleotides, random peptides, or entire loops at corresponding positions within the nucleic acid which encodes the binding site (see e.g., U.S. Pub. No. 20040132028). The location of the amino acid positions can be identified by investigation of the crystal structure of the binding site in complex with the target molecule. Candidate positions for randomization include loops, flat surfaces, helices, and binding cavities of the binding site. In certain embodiments, amino acids within the binding site that are likely candidates for diversification can be identified using techniques known in the art. Following randomization, the diversified library may then be subjected to a selection or screening procedure to obtain binding molecules with the desired binding characteristics, e.g., specific binding platelets using methods known in the art. Selection can be achieved by art-recognized methods such as phage display, yeast display, or ribosome display. In one embodiment, molecules known in the art to bind to platelets may be employed in the constructs of the invention. For example, peptides which bind to GPIba as described in the art (e.g., PS4, 0S1, or 0S2) may be used (Benard et al. 2008. Biochemistry 47:4674-4682).

In one example, the targeting moieties is linked to an Fc moiety.

In still other embodiments, the fusion compound further comprises a scFc linker (X), which links the first immunoglobulin constant region or a portion thereof to the second immunoglobulin constant region or a portion thereof. The term “scFv linker” as used herein means a processable linker comprising at least one intracellular processing site and a linker. In one embodiment, an intracellular processing site is interposed between the procoagulant compound and the linker, wherein the linker links the compound with the first immunoglobulin constant region or a portion thereof. In another embodiment, an intracellular processing site is interposed between the linker and the first immunoglobulin constant region or a portion thereof, wherein the linker links the compound with the first immunoglobulin constant region or a portion thereof. In other embodiments, an intracellular processing site is interposed between the first immunoglobulin constant region or a portion thereof and the linker, wherein the linker links the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof. In still other embodiments, an intracellular processing site is interposed between the linker and the second immunoglobulin constant region or a portion thereof, wherein the linker links the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof. In yet other embodiments, the fusion compound can have more than one intracellular processing site, two, three, or four. The intracellular processing site inserted therein can be processed (cleaved) by an intracellular processing enzyme upon expression in a host cell, thereby allowing formation of a zymogen-like heterodimer. Examples of the intracellular processing enzymes include furin, a yeast Kex2, PCSK1 (also known as PC1/Pc3), PCSK2 (also known as PC2), PCSK3 (also known as furin or PACE), PCSK4 (also known as PC4), PCSK5 (also known as PC5 or PC6), PCSK6 (also known as PACE4), or PCSK7 (also known as PC7/LPC, PC8, or SPC7). Other processing sites are known in the art.

Half-Life Extender Heterologous Moieties

In certain aspects, the procoagulant compound can be fused to a heterologous moiety, forming a fusion protein. In one embodiment, a heterologous moiety is a half-like extender, i.e., a heterologous moiety which increases the in vivo half-life of the procoagulant compound with respect to the in vivo half-life of the corresponding fusion compound lacking such heterologous moiety. The in vivo half-life can be determined by any method known to those of skill in the art, e.g., activity assays (chromogenic assay or one stage clotting aPTT assay), ELISA, etc.

In some embodiments, the presence of one or more half-life extenders results in the half-life of the procoagulant compound to be increased compared to the half life of the corresponding procoagulant compound lacking such one or more half-life extenders. The half-life of the procoagulant compound comprising a half-life extender is at least about 1.5 times, at least about 2 times, at least about 2.5 times, at least about 3 times, at least about 4 times, at least about 5 times, at least about 6 times, at least about 7 times, at least about 8 times, at least about 9 times, at least about 10 times, at least about 11 times, or at least about 12 times longer than the in vivo half-life of the corresponding procoagulant compound lacking such half-life extender.

In one embodiment, the half-life of the procoagulant compound linked to a half-life extender is about 1.5-fold to about 20-fold, about 1.5 fold to about 15 fold, or about 1.5 fold to about 10 fold longer than the in vivo half-life of the corresponding procoagulant compound not linked to such half-life extender. In another embodiment, the half-life of the procoagulant compound linked to a half-life extender is extended about 2-fold to about 10-fold, about 2-fold to about 9-fold, about 2-fold to about 8-fold, about 2-fold to about 7-fold, about 2-fold to about 6-fold, about 2-fold to about 5-fold, about 2-fold to about 4-fold, about 2-fold to about 3-fold, about 2.5-fold to about 10-fold, about 2.5-fold to about 9-fold, about 2.5-fold to about 8-fold, about 2.5-fold to about 7-fold, about 2.5-fold to about 6-fold, about 2.5-fold to about 5-fold, about 2.5-fold to about 4-fold, about 2.5-fold to about 3-fold, about 3-fold to about 10-fold, about 3-fold to about 9-fold, about 3-fold to about 8-fold, about 3-fold to about 7-fold, about 3-fold to about 6-fold, about 3-fold to about 5-fold, about 3-fold to about 4-fold, about 4-fold to about 6 fold, about 5-fold to about 7-fold, or about 6-fold to about 8 fold as compared to the in vivo half-life of the corresponding procoagulant compound not linked to such half-life extender.

In other embodiments, the half-life of the procoagulant compound linked to a half-life extender is at least about 10 hours, at least about 17 hours, at least about 18 hours, at least about 19 hours, at least about 20 hours, at least about 21 hours, at least about 22 hours, at least about 23 hours, at least about 24 hours, at least about 25 hours, at least about 26 hours, at least about 27 hours, at least about 28 hours, at least about 29 hours, at least about 30 hours, at least about 31 hours, at least about 32 hours, at least about 33 hours, at least about 34 hours, at least about 35 hours, at least about 36 hours, at least about 48 hours, at least about 60 hours, at least about 72 hours, at least about 84 hours, at least about 96 hours, or at least about 108 hours.

In still other embodiments, the half-life of the procoagulant compound linked to a half-life extender is about 15 hours to about two weeks, about 16 hours to about one week, about 17 hours to about one week, about 18 hours to about one week, about 19 hours to about one week, about 20 hours to about one week, about 21 hours to about one week, about 22 hours to about one week, about 23 hours to about one week, about 24 hours to about one week, about 36 hours to about one week, about 48 hours to about one week, about 60 hours to about one week, about 24 hours to about six days, about 24 hours to about five days, about 24 hours to about four days, about 24 hours to about three days, or about 24 hours to about two days.

In some embodiments, the average half-life per subject of the procoagulant compound linked to a half-life extender is about 15 hours, about 16 hours, about 17 hours, about 18 hours, about 19 hours, about 20 hours, about 21 hours, about 22 hours, about 23 hours, about 24 hours (1 day), about 25 hours, about 26 hours, about 27 hours, about 28 hours, about 29 hours, about 30 hours, about 31 hours, about 32 hours, about 33 hours, about 34 hours, about 35 hours, about 36 hours, about 40 hours, about 44 hours, about 48 hours (2 days), about 54 hours, about 60 hours, about 72 hours (3 days), about 84 hours, about 96 hours (4 days), about 108 hours, about 120 hours (5 days), about six days, about seven days (one week), about eight days, about nine days, about 10 days, about 11 days, about 12 days, about 13 days, or about 14 days.

(a) Low Complexity Polypeptides

In certain aspects, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety comprising a polypeptide with low compositional and/or structural complexity (e.g., a disordered polypeptide with no secondary or tertiary structure in solution under physiologic conditions).

(b) CTP

In certain aspects, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety comprising a 13 subunit of C-terminal peptide (CTP) of the human chorionic gonadotropin or fragment, variant, or derivative thereof. One or more CTP peptides inserted into a recombinant protein is known to increase the in vivo half-life of that protein. See, e.g., U.S. Pat. No. 5,712,122, incorporated by reference herein in its entirety. Exemplary CTP peptides include DPRFQDSSSSKAPPPSLPSPSRLPGPSDTPIL (SEQ ID NO: 27) or SSSSKAPPPSLPSPSRLPGPSDTPILPQ (SEQ ID NO: 28). See, e.g., U.S. Patent Application Publication No. US 2009/0087411 A1, incorporated herein by reference in its entirety.

(c) Albumin or Fragment, or Variant Thereof

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety comprising albumin or a functional fragment thereof. Human serum albumin (HSA, or HA), a protein of 609 amino acids in its full-length form, is responsible for a significant proportion of the osmotic pressure of serum and also functions as a carrier of endogenous and exogenous ligands. The term “albumin” as used herein includes full-length albumin or a functional fragment, variant, derivative, or analog thereof. Examples of albumin or the fragments or variants thereof are disclosed in US Pat. Publ. Nos. 2008/0194481A1, 2008/0004206 A1, 2008/0161243 A1, 2008/0261877 A1, or 2008/0153751 A1 or PCT Appl. Publ. Nos. 2008/033413 A2, 2009/058322 A1, or 2007/021494 A2, which are incorporated herein by reference in their entireties.

In one embodiment, the heterologous moiety is albumin, a fragment, or a variant thereof which is further linked to a heterologous moiety selected from the group consisting of an immunoglobulin constant region or portion thereof (e.g., an Fc region), a PAS sequence, HES, and PEG.

(d) Albumin Binding Moiety

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is an albumin binding moiety, which comprises an albumin binding peptide, a bacterial albumin binding domain, an albumin-binding antibody fragment, or any combinations thereof.

For example, the albumin binding protein can be a bacterial albumin binding protein, an antibody or an antibody fragment including domain antibodies (see U.S. Pat. No. 6,696,245). An albumin binding protein, for example, can be a bacterial albumin binding domain, such as the one of streptococcal protein G (Konig, T. and Skerra, A. (1998) J. Immunol. Methods 218, 73-83). Other examples of albumin binding peptides that can be used as conjugation partner are, for instance, those having a Cys-Xaa₁-Xaa₂-Xaa₃-Xaa₄-Cys (SEQ ID NO: 32) consensus sequence, wherein Xaa₁ is Asp, Asn, Ser, Thr, or Trp; Xaa₂ is Asn, Gin, His, Ile, Leu, or Lys; Xaa₃ is Ala, Asp, Phe, Trp, or Tyr; and Xaa₄ is Asp, Gly, Leu, Phe, Ser, or Thr as described in US patent application 2003/0069395 or Dennis et al. (Dennis et al. (2002) J. Biol. Chem. 277, 35035-35043).

Domain 3 from streptococcal protein G, as disclosed by Kraulis et al., FEBS Lett. 378:190-194 (1996) and Linhult et al., Protein Sci. 11:206-213 (2002) is an example of a bacterial albumin-binding domain. Examples of albumin-binding peptides include a series of peptides having the core sequence DICLPRWGCLW (SEQ ID NO:29). See, e.g., Dennis et al., J. Biol. Chem. 2002, 277: 35035-35043 (2002). Examples of albumin-binding antibody fragments are disclosed in Muller and Kontermann, Curr. Opin. Mol. Ther. 9:319-326 (2007); Roovers et al., Cancer Immunol. Immunother. 56:303-317 (2007), and Holt et al., Prot. Eng. Design Sci., 21:283-288 (2008), which are incorporated herein by reference in their entireties. An example of such albumin binding moiety is 2-(3-maleimidopropanamido)-6-(4-(4-iodophenyl)butanamido) hexanoate (“Albu” tag) as disclosed by Trussel et al., Bioconjugate Chem. 20:2286-2292 (2009).

(e) PAS Sequence

In other embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which comprises a PAS sequence. A PAS sequence, as used herein, means an amino acid sequence comprising mainly alanine and serine residues or comprising mainly alanine, serine, and proline residues, the amino acid sequence forming random coil conformation under physiological conditions. Accordingly, the PAS sequence is a building block, an amino acid polymer, or a sequence cassette comprising, consisting essentially of, or consisting of alanine, serine, and proline which can be used as a part of the heterologous moiety in the procoagulant compound. Yet, the skilled person is aware that an amino acid polymer also may form random coil conformation when residues other than alanine, serine, and proline are added as a minor constituent in the PAS sequence. The term “minor constituent” as used herein means that amino acids other than alanine, serine, and proline may be added in the PAS sequence to a certain degree, e.g., up to about 12%, i.e., about 12 of 100 amino acids of the PAS sequence, up to about 10%, i.e. about 10 of 100 amino acids of the PAS sequence, up to about 9%, i.e., about 9 of 100 amino acids, up to about 8%, i.e., about 8 of 100 amino acids, about 6%, i.e., about 6 of 100 amino acids, about 5%, i.e., about 5 of 100 amino acids, about 4%. i.e., about 4 of 100 amino acids, about 3%, i.e., about 3 of 100 amino acids, about 2%, i.e., about 2 of 100 amino acids, about 1%, i.e., about 1 of 100 of the amino acids. The amino acids different from alanine, serine and proline may be selected from the group consisting of Arg, Asn, Asp, Cys, Gin, Glu, Gly, His, Ile, Leu, Lys, Met, Phe, Thr, Trp, Tyr, and Val.

Under physiological conditions, the PAS sequence stretch forms a random coil conformation and thereby can mediate an increased in vivo and/or in vitro stability to procoagulant compound. Since the random coil domain does not adopt a stable structure or function by itself, the biological activity mediated by the Pep1 and/or Pep2 polypeptides in the procoagulant compound is essentially preserved. In other embodiments, the PAS sequences that form random coil domain are biologically inert, especially with respect to proteolysis in blood plasma, immunogenicity, isoelectric point/electrostatic behaviour, binding to cell surface receptors or internalisation, but are still biodegradable, which provides clear advantages over synthetic polymers such as PEG.

Non-limiting examples of the PAS sequences forming random coil conformation comprise an amino acid sequence selected from the group consisting of ASPAAPAPASPAAPAPSAPA (SEQ ID NO: 33), AAPASPAPAAPSAPAPAAPS (SEQ ID NO: 34), APSSPSPSAPSSPSPASPSS (SEQ ID NO: 35), APSSPSPSAPSSPSPASPS (SEQ ID NO: 36), SSPSAPSPSSPASPSPSSPA (SEQ ID NO: 37), AASPAAPSAPPAAASPAAPSAPPA (SEQ ID NO: 38), and ASAAAPAAASAAASAPSAAA (SEQ ID NO: 39), or any combinations thereof. Additional examples of PAS sequences are known from, e.g., US Pat. Publ. No. 2010/0292130 A1 and PCT Appl. Publ. No. WO 2008/155134 A1.

(f) HAP Sequence

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is a glycine-rich homo-amino-acid polymer (HAP). The HAP sequence can comprise a repetitive sequence of glycine, which has at least 50 amino acids, at least 100 amino acids, 120 amino acids, 140 amino acids, 160 amino acids, 180 amino acids, 200 amino acids, 250 amino acids, 300 amino acids, 350 amino acids, 400 amino acids, 450 amino acids, or 500 amino acids in length. In one embodiment, the HAP sequence is capable of extending half-life of a moiety fused to or linked to the HAP sequence. Non-limiting examples of the HAP sequence includes, but are not limited to (Gly)_(n) (SEQ ID NO: 40), (Gly₄Ser)_(n) (SEQ ID NO: 41) or S(Gly₄Ser)_(n) (SEQ ID NO: 42), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20. In one embodiment, n is 20, 21, 22, 23, 24, 25, 26, 26, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40. In another embodiment, n is 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, or 200.

(g) Transferrin or Fragment Thereof

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is transferrin or a fragment thereof. Any transferrin may be used to make the conjugates of the invention. As an example, wild-type human Tf (Tf) is a 679 amino acid protein, of approximately 75 KDa (not accounting for glycosylation), with two main domains, N (about 330 amino acids) and C (about 340 amino acids), which appear to originate from a gene duplication. See GenBank accession numbers NM001063, XM002793, M12530, XM039845, XM 039847 and S95936 (www.ncbi.nlm.nih.gov/), all of which are herein incorporated by reference in their entirety. Transferrin comprises two domains, N domain and C domain. N domain comprises two subdomains, N1 domain and N2 domain, and C domain comprises two subdomains, C1 domain and C2 domain.

In one embodiment, the transferrin heterologous moiety includes a transferrin splice variant. In one example, a transferrin splice variant can be a splice variant of human transferrin, e.g., Genbank Accession AAA61140. In another embodiment, the transferrin portion of the chimeric protein includes one or more domains of the transferrin sequence, e.g., N domain, C domain, N1 domain, N2 domain, C1 domain, C2 domain or any combinations thereof.

(h) Polymer, e.g., Polyethylene Glycol (PEG)

In other embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is a soluble polymer known in the art, including, but not limited to, polyethylene glycol, ethylene glycol/propylene glycol copolymers, carboxymethylcellulose, dextran, or polyvinyl alcohol. Also provided by the invention are procoagulant compounds of the invention comprising heterologous moieties which may provide additional advantages such as increased solubility, stability and circulating time of the polypeptide, or decreased immunogenicity (see U.S. Pat. No. 4,179,337). Such heterologous moieties for modification can be selected from the group consisting of water soluble polymers including, but not limited to, polyethylene glycol, ethylene glycol/propylene glycol copolymers, carboxymethylcellulose, dextran, and polyvinyl alcohol, poly(alkylene oxide), poly(vinyl pyrrolidone), polyoxazoline, or poly(acryloylmorpholine).

The polymer can be of any molecular weight, and can be branched or unbranched. For polyethylene glycol, in one embodiment, the molecular weight is between about 1 kDa and about 100 kDa for ease in handling and manufacturing. Other sizes may be used, depending on the desired profile (e.g., the duration of sustained release desired, the effects, if any on biological activity, the ease in handling, the degree or lack of antigenicity and other known effects of the polyethylene glycol to a protein or analog). For example, the polyethylene glycol may have an average molecular weight of about 200, 500, 1000, 1500, 2000, 2500, 3000, 3500, 4000, 4500, 5000, 5500, 6000, 6500, 7000, 7500, 8000, 8500, 9000, 9500, 10,000, 10,500, 11,000, 11,500, 12,000, 12,500, 13,000, 13,500, 14,000, 14,500, 15,000, 15,500, 16,000, 16,500, 17,000, 17,500, 18,000, 18,500, 19,000, 19,500, 20,000, 25,000, 30,000, 35,000, 40,000, 45,000, 50,000, 55,000, 60,000, 65,000, 70,000, 75,000, 80.000, 85,000, 90,000, 95,000, or 100,000 kDa.

In some embodiments, the polyethylene glycol may have a branched structure. Branched polyethylene glycols are described, for example, in U.S. Pat. No. 5,643,575; Morpurgo et al., Appl. Biochem. Biotechnol. 56:59-72 (1996); Vorobjev et al., Nucleosides Nucleotides 18:2745-2750 (1999); and Caliceti et al., Bioconjug. Chem. 10:638-646 (1999), each of which is incorporated herein by reference in its entirety.

The number of polyethylene glycol moieties attached to each fusion compound of the invention (i.e., the degree of substitution) may also vary. For example, the PEGylated fusion compound may be linked, on average, to 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 15, 17, 20, or more polyethylene glycol molecules. Similarly, the average degree of substitution within ranges such as 1-3, 2-4, 3-5, 4-6, 5-7, 6-8, 7-9, 8-10, 9-11, 10-12, 11-13, 12-14, 13-15, 14-16, 15-17, 16-18, 17-19, or 18-20 polyethylene glycol moieties per protein molecule. Methods for determining the degree of substitution are discussed, for example, in Delgado et al., Crit. Rev. Thera. Drug Carrier Sys. 9:249-304 (1992).

In one example, the heterologous moiety is a water-soluble polymer, e.g., a straight or branched polyethylene glycol (PEG) moieties, straight or branched polypropylene glycol (PPG) moiety, a hydroxyethyl starch (HES) moiety, or a half-life extension polypeptide (e.g., XTEN; see, e.g., Schellenberger V. et al., Nat Biotechnol. 2009 December; 27(12):1186-90, US20100189682, PCT/US07/05952, U.S. Ser. No. 12/228,859, U.S. Ser. No. 12/646,566, PCT/US08/09787, U.S. Ser. No. 12/699,761, and PCT/US2010/23106, each of which is incorporated herein by reference in its entirety). The polymer can be attached to the N-terminus, the C-terminus of the peptide sequence or an internal amino acid of the compound or the polypeptide. In one example, the polymer is attached to the N-terminal amino acid, e.g. via an amide bond. In another example, the polymer is attached to the C-terminal amino acid via an amide bond. In yet another example, the polymer is attached to the peptide sequence through derivatization of an amino acid side chain located at an internal position of the amino acid sequence. For example, the polymer is attached to the peptide sequence via derivatization of a tyrosine side chain, a lysine side chain or a aspartic acid or glutamic acid side chain.

Suitable methods of PEGylation are disclosed, e.g., in U.S. Pat. No. 5,122,614 to Zalipsky et al., and U.S. Pat. No. 5,539,063 to Hakimi et al., all of which PEGylation methods are incorporated herein by reference. Various molecular weights of PEG may be used, suitably from 1000 Da to 80,000 Da (or from 5000 Da to 60,000 DA). In one example, the PEG is monodisperse, meaning that there is little variation in molecular weight between PEG molecules. PEGylation may improve the solubility and plasma half-life of a peptide.

(i) XTEN Moieties

In certain aspects, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 ion is covalently linked to at least one heterologous moiety that is or comprises an XTEN polypeptide or fragment, variant, or derivative thereof. As used here “XTEN polypeptide” refers to extended length polypeptides with non-naturally occurring, substantially non-repetitive sequences that are composed mainly of small hydrophilic amino acids, with the sequence having a low degree or no secondary or tertiary structure under physiologic conditions. As a heterologous moiety, XTENs can serve as a half-life extension moiety. In addition, XTEN can provide desirable properties including but are not limited to enhanced pharmacokinetic parameters and solubility characteristics.

The incorporation of a heterologous moiety comprising an XTEN sequence into a conjugate of the invention can confer one or more of the following advantageous properties to the resulting conjugate: conformational flexibility, enhanced aqueous solubility, high degree of protease resistance, low immunogenicity, low binding to mammalian receptors, or increased hydrodynamic (or Stokes) radii.

In certain aspects, an XTEN moiety can increase pharmacokinetic properties such as longer in vivo half-life or increased area under the curve (AUC), so that a fusion compound of the invention stays in vivo and has procoagulant activity for an increased period of time compared to a fusion compound with the same but without the XTEN heterologous moiety.

Examples of XTEN moieties that can be used as heterologous moieties in procoagulant conjugates of the invention are disclosed, e.g., in U.S. Patent Publication Nos. 2010/0239554 A1, 2010/0323956 A1, 2011/0046060 A1, 2011/0046061 A1, 2011/0077199 A1, or 2011/0172146 A1, or International Patent Publication Nos. WO 2010091122 A1, WO 2010144502 A2, WO 2010144508 A1, WO 2011028228 A1, WO 2011028229 A1, or WO 2011028344 A2, each of which is incorporated by reference herein in its entirety.

-   -   (j) Hydroxyethyl Starch (HES)

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is hydroxyethyl starch (HES) or a derivative thereof. Hydroxyethyl starch (HES) is a derivative of naturally occurring amylopectin and is degraded by alpha-amylase in the body. HES is a substituted derivative of the carbohydrate polymer amylopectin, which is present in corn starch at a concentration of up to 95% by weight. HES exhibits advantageous biological properties and is used as a blood volume replacement agent and in hemodilution therapy in the clinics (Sommermeyer et al., Krankenhauspharmazie, 8(8), 271-278 (1987); and Weidler et al., Arzneim.-Forschung/Drug Res., 41, 494-498 (1991)).

Amylopectin contains glucose moieties, wherein in the main chain alpha-1,4-glycosidic bonds are present and at the branching sites alpha-1,6-glycosidic bonds are found. The physical-chemical properties of this molecule are mainly determined by the type of glycosidic bonds. Due to the nicked alpha-1,4-glycosidic bond, helical structures with about six glucose-monomers per turn are produced. The physico-chemical as well as the biochemical properties of the polymer can be modified via substitution. The introduction of a hydroxyethyl group can be achieved via alkaline hydroxyethylation. By adapting the reaction conditions it is possible to exploit the different reactivity of the respective hydroxy group in the unsubstituted glucose monomer with respect to a hydroxyethylation. Owing to this fact, the skilled person is able to influence the substitution pattern to a limited extent.

HES is mainly characterized by the molecular weight distribution and the degree of substitution. The degree of substitution, denoted as DS, relates to the molar substitution, is known to the skilled people. See Sommermeyer et al., Krankenhauspharmazie, 8(8), 271-278 (1987), as cited above, in particular p. 273.

In one embodiment, hydroxyethyl starch has a mean molecular weight (weight mean) of from 1 to 300 kD, from 2 to 200 kD, from 3 to 100 kD, or from 4 to 70 kD, hydroxyethyl starch can further exhibit a molar degree of substitution of from 0.1 to 3, preferably 0.1 to 2, more preferred, 0.1 to 0.9, preferably 0.1 to 0.8, and a ratio between C2:C6 substitution in the range of from 2 to 20 with respect to the hydroxyethyl groups. A non-limiting example of HES having a mean molecular weight of about 130 kD is a HES with a degree of substitution of 0.2 to 0.8 such as 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, or 0.8, preferably of 0.4 to 0.7 such as 0.4, 0.5, 0.6, or 0.7. In a specific embodiment, HES with a mean molecular weight of about 130 kD is VOLUVEN® from Fresenius. VOLUVEN® is an artificial colloid, employed, e.g., for volume replacement used in the therapeutic indication for therapy and prophylaxis of hypovolemia. The characteristics of VOLUVEN® are a mean molecular weight of 130,000+/−20,000 D, a molar substitution of 0.4 and a C2:C6 ratio of about 9:1. In other embodiments, ranges of the mean molecular weight of hydroxyethyl starch are, e.g., 4 to 70 kD or 10 to 70 kD or 12 to 70 kD or 18 to 70 kD or 50 to 70 kD or 4 to 50 kD or 10 to 50 kD or 12 to 50 kD or 18 to 50 kD or 4 to 18 kD or 10 to 18 kD or 12 to 18 kD or 4 to 12 kD or 10 to 12 kD or 4 to 10 kD. In still other embodiments, the mean molecular weight of hydroxyethyl starch employed is in the range of from more than 4 kD and below 70 kD, such as about 10 kD, or in the range of from 9 to 10 kD or from 10 to 11 kD or from 9 to 11 kD, or about 12 kD, or in the range of from 11 to 12 kD) or from 12 to 13 kD or from 11 to 13 kD, or about 18 kD, or in the range of from 17 to 18 kD or from 18 to 19 kD or from 17 to 19 kD, or about 30 kD, or in the range of from 29 to 30, or from 30 to 31 kD, or about 50 kD, or in the range of from 49 to 50 kD or from 50 to 51 kD or from 49 to 51 kD.

In certain embodiments, the heterologous moiety can be a mixture of hydroxyethyl starches having different mean molecular weights and/or different degrees of substitution and/or different ratios of C2:C6 substitution. Therefore, mixtures of hydroxyethyl starches may be employed having different mean molecular weights and different degrees of substitution and different ratios of C2:C6 substitution, or having different mean molecular weights and different degrees of substitution and the same or about the same ratio of C2:C6 substitution, or having different mean molecular weights and the same or about the same degree of substitution and different ratios of C2:C6 substitution, or having the same or about the same mean molecular weight and different degrees of substitution and different ratios of C2:C6 substitution, or having different mean molecular weights and the same or about the same degree of substitution and the same or about the same ratio of C2:C6 substitution, or having the same or about the same mean molecular weights and different degrees of substitution and the same or about the same ratio of C2:C6 substitution, or having the same or about the same mean molecular weight and the same or about the same degree of substitution and different ratios of C2:C6 substitution, or having about the same mean molecular weight and about the same degree of substitution and about the same ratio of C2:C6 substitution.

(k) Polysialic Acids (PSA)

In certain embodiments, the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety, which is a polysialic acids (PSAs) or a derivative thereof. Polysialic acids (PSAs) are naturally occurring unbranched polymers of sialic acid produced by certain bacterial strains and in mammals in certain cells Roth J., et al. (1993) in Polysialic Acid: From Microbes to Man, eds Roth J., Rutishauser U., Troy F. A. (Birkhtiuser Verlag, Basel, Switzerland), pp 335-348. They can be produced in various degrees of polymerisation from n=about 80 or more sialic acid residues down to n=2 by limited acid hydrolysis or by digestion with neuraminidases, or by fractionation of the natural, bacterially derived forms of the polymer. The composition of different polysialic acids also varies such that there are homopolymeric forms i.e. the alpha-2,8-linked polysialic acid comprising the capsular polysaccharide of E. coli strain K1 and the group-B meningococci, which is also found on the embryonic form of the neuronal cell adhesion molecule (N-CAM). Heteropolymeric forms also exist-such as the alternating alpha-2,8 alpha-2,9 polysialic acid of E. coli strain K92 and group C polysaccharides of N. meningitidis. Sialic acid may also be found in alternating copolymers with monomers other than sialic acid such as group W135 or group Y of N. meningitidis. Polysialic acids have important biological functions including the evasion of the immune and complement systems by pathogenic bacteria and the regulation of glial adhesiveness of immature neurons during foetal development (wherein the polymer has an anti-adhesive function) Cho and Troy, P.N.A.S., USA, 91 (1994) 11427-11431, although there are no known receptors for polysialic acids in mammals. The alpha-2,8-linked polysialic acid of E. coli strain K1 is also known as ‘colominic acid’ and is used (in various lengths) to exemplify the present invention. Various methods of attaching or conjugating polysialic acids to a polypeptide have been described (for example, see U.S. Pat. No. 5,846,951; WO-A-0187922, and US 2007/0191597 A1, which are incorporated herein by reference in their entireties.

(l) Clearance Receptors

In some embodiments the procoagulant compound comprising an amino acid sequence at least 95% identical to SEQ ID NO: 3 is linked to a heterologous moiety comprising a clearance receptor, fragment, variant, or derivative thereof. For example, soluble forms of clearance receptors, such as the low density lipoprotein-related protein receptor LRP1, or fragments thereof, can block binding of a polypeptide (e.g., FVIII or FIX) to clearance receptors and thereby extend its in vivo half-life.

LRP1 is a 600 kDa integral membrane protein that is implicated in the receptor-mediate clearance of a variety of proteins. See, e.g., Lenting et al., Haemophilia 16:6-16 (2010). LRP1 also mediates clearance of Factor IX (see, e.g., Strickland & Medved. J. Thromb. Haemostat. 4:1484-1486 (2006).

Other suitable clearance receptors are, e.g., LDLR (low-density lipoprotein receptor), VLDLR (very low-density lipoprotein receptor), and megalin (LRP-2), or fragments thereof. See, e.g., Bovenschen et al., Blood 106:906-912 (2005); Bovenschen, Blood 116:5439-5440 (2010); Martinelli et al., Blood 116:5688-5697 (2010).

Linker (L)

The linker is used to covalently link the procoagulant compound to the immunoglobulin constant region or a portion thereof or a heterologous moiety (e.g., a platelet targeting moiety, or a blood coagulation factor selected from FVIIa, FVIII, and FIX). The linker can also be used to covalently link the first immunoglobulin constant region or a portion thereof and the second immunoglobulin constant region or a portion thereof. Fusion compounds can contain more than one linker.

In some embodiments, the linker is a hydrophilic linker, e.g., a peptide linker, a gly-ser polypeptide linker such as those comprised of Gly and Ser or Gly and Val. An exemplary gly/ser polypeptide linker comprises the amino acid sequence (Gly₄ Ser)n (e.g., (GGGGS)_(n) where n=1-50) (SEQ ID NO: 26). In one embodiment, n=1. In one embodiment, n=2. In another embodiment, n3, i.e., (Gly₄Ser)₃ (SEQ ID NO: 51). In another embodiment, n=4, i.e., (Gly₄ Ser)₄ (SEQ ID NO: 23). In another embodiment, n=5. In yet another embodiment, n=6. In another embodiment, n=7. In yet another embodiment, n=8. In another embodiment, n=9. In yet another embodiment, n=10. Another exemplary gly/ser polypeptide linker comprises the amino acid sequence Ser(Gly₄Ser)n (SEQ ID NO: 42). In one embodiment, n=1. In one embodiment, n=2. In a preferred embodiment, n=3. In another embodiment, n=4. In another embodiment, n=5. In yet another embodiment, n=6.

In other embodiments, the linker is a water-soluble polymer, such as polyethylene glycol (PEG) or polypropylene glycol (PPG). In one example, the linker is a PEG moiety. In other embodiments, the linker is a hydroxyethyl starch (HES) moiety.

The compound can be coupled with the heterologous moiety or the polypeptide chemically or using recombinant techniques, e.g., by recombinant expression of a fusion compound.

Chemical linkage can be achieved by linking together chemical moieties present on the compound and on the heterologous moiety or the polypeptide, e.g., using moieties such as amino, carboxyl, sulfydryl, hydroxyl groups, and carbohydrate groups. A variety of homo- and hetero-bifunctional linker molecules can be used that have groups that are activated, or can be activated to link these moieties. Some useful reactive groups on linker molecules include maleimides, N-hydroxy-succinimide esters and hydrazides. Many different spacers of different chemical composition and length can be used for separating these reactive groups including, for example, polyethylene glycol (PEG), aliphatic groups, alkylene groups, cycloalkylene groups, fused or linked aryl groups, peptides and/or peptidyl mimetics, e.g., peptides having from one to 20 amino acids or amino acid analogs.

In one embodiment, the linker is a non-cleavable linker. In one example according to this embodiment, the linker is a “gly-ser polypeptide linker”, e.g., includes the amino acid sequence (GGS)_(n) (SEQ ID NO: 52), (GGGS)_(n) (SEQ ID NO: 25), or (GGGGS)_(n) (SEQ ID NO: 26) where n is 1-50 (e.g., n is 6).

In another example, the linker is cleavable (e.g., cleavable in vivo). In one example, the compound is linked to the immunoglobulin constant region or a portion thereof or a heterologous moiety in such a way that the compound is released from the heterologous moiety or the immunoglobulin constant region or a portion thereof in vivo (e.g., near the site of biological activity of the compound in the body). In one example, the cleavage of such linker liberates the compound from a potential activity-compromising steric hindrance that may be caused by the heterologous moiety (e.g., PEG moiety).

In some embodiments, the linker is a peptide linker that is proteolytically cleavable. In other embodiments, the linker is cleavable by an enzyme from the coagulation cascade.

In one embodiment, the linker is cleavable by an enzyme from the coagulation cascade. In one example the linker includes a thrombin cleavable site (thrombin cleavable substrate moiety) or a FXIa cleavable site (FXIa cleavable substrate moiety). Exemplary FXIa cleavage sites include: TQSFNDFTR (SEQ ID NO: 43) and SVSQTSKLTR (SEQ ID NO: 44). Exemplary thrombin cleavage sites include: DFLAEGGGVR (SEQ ID NO: 45), DFLAEEGGGVR (SEQ ID NO: 46), TTKIKPR (SEQ ID NO: 47), ALVPR (SEQ ID NO: 48), ALRPR (SEQ ID NO: 49) and ALRPRVVGGA (SEQ ID NO: 50). In one embodiment, the thrombin cleavable site includes (D-Phe)-Pro-Arg. In one embodiment, the thrombin cleavable site includes (D-Phe)-Pip-Arg, wherein Pip is pipecolic acid.

In another example, the linker includes a thrombin-cleavable chimeric protein, such as those disclosed in U.S. Pat. No. 7,589,178 to Le Bonniec, which is herein incorporated by reference in its entirety.

Biological Activity

In various embodiments, the fusion compound of the present disclosure have procoagulant activity. It will be appreciated that different assays are available to measure procoagulant activity. In one example, the fusion compound has procoagulant activity when it shows activity in at least one of: a FXa generation assay, a thrombin generation assay (TGA), and a rotational thromboelastometry (ROTEM) assay.

A fusion compound of the present disclosure may promote coagulation in plasma depleted of FV, FVII, FVIII, FIX, FX, FXI, or vWF. In one example, the fusion compound of the present disclosure promotes thrombin generation and/or fibrin deposition in plasma in which FVIII is depleted or absent. This type of activity is referred to as coagulation FVIII activity. Where the plasma is from an individual lacking FVIII or having reduced levels of FVIII, the activity is typically referred to as FVIII equivalent activity. Where the plasma contains inhibitors against FVIII, the activity is typically referred to as FVIII inhibitor bypassing equivalent activity. Other procoagulant activities include FV activity, FVII activity, FX activity and FXI activity.

Individual fusion compound can vary in their relative efficacy between different types of assay. Therefore, even if a fusion compound appears to have a low efficacy in a particular assay, it may nevertheless possess a suitably high level of procoagulant activity in another assay.

Other suitable assays useful to determine procoagulant activity include those disclosed, e.g., in Patent Application Publication U.S. 2010/0022445 to Scheiflinger and Dockal, which is incorporated herein by reference in its entirety.

Methods of Making the Fusion Compounds

The invention also includes a method of reducing or preventing aggregates comprising a procoagulant compound comprising fusing a procoagulant compound to an immunoglobulin constant region or a portion thereof, wherein the procoagulant compound comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3). In one embodiment, the procoagulant compound comprises SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3). In another embodiment, the fusion compound forms less aggregates compared to a compound consisting of the procoagulant compound. In other embodiments, the fusion compound forms at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 100% less aggregates compared to a compound consisting of the procoagulant compound.

In still other embodiments, the immunoglobulin constant region or a portion thereof in the fusion protein is an Fc fragment or an FcRn binding partner. In certain embodiments, the procoagulant compound is linked to the immunoglobulin constant region or a portion thereof by a linker. In some embodiments, the linker comprises (GGGGS)_(n) (SEQ ID NO:22), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., (GGGGS)₆ (SEQ ID NO: 24).

In other embodiments, the fusion compound further comprises an additional immunoglobulin constant region or a portion thereof, wherein the additional immunoglobulin constant region or a portion thereof is covalently linked to the immunoglobulin constant region or a portion thereof. In yet other embodiments, the additional immunoglobulin constant region or a portion thereof is linked to the immunoglobulin constant region or a portion thereof by a second linker. For example, the second linker can be (GGGGS), (SEQ ID NO: 22), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., (GGGGS)₄ (SEQ ID NO: 23). In other embodiments, the fusion compound further comprises a signal peptide, e.g., METDTLLLWVLLLWVPGSTG (SEQ ID NO: 5).

In other embodiments, the fusion compound comprises an amino acid sequence of SEQ ID NO: 2. In yet other embodiments, the fusion compound is encoded by a nucleotide sequence of SEQ ID NO: 1.

The fusion compound of the present disclosure can be produced by chemical synthesis, recombinant DNA technology, biochemical or enzymatic fragmentation of larger molecules, combinations of the foregoing or by any other method.

In one example, the method comprises forming the amino acid sequence of the compound, or a retro-, inverso- or retro-inverso variant thereof using solid-phase peptide synthesis. The methods of making the fusion compounds are known to those of skill in the art.

For example, the fusion compound of the present disclosure can be synthesized using solid-phase peptide synthesis as described in “Fmoc Solid Phase Peptide Synthesis—A Practical Approach”, edited by W. C. Chan, P. D. White, Oxford University Press, New York 2000 and references therein. Temporary N-amino group protection is afforded, e.g., by a 9-fluorenylmethyloxycarbonyl (Fmoc) group. Repetitive cleavage of this highly base-labile protecting group is effected, e.g., using 20% piperidine in N,N-dimethylformamide. Side-chain functionalities may be protected as their butyl ethers (in the case of serine, threonine and tyrosine), butyl esters (in the case of glutamic acid and aspartic acid), butyloxycarbonyl derivative (in the case of lysine and histidine), trityl derivative (in the case of cysteine, asparagine and glutamine) and 4-methoxy-2,3,6-trimethylbenzenesulphonyl derivative (in the case of arginine). The solid-phase support can be based on a polydimethyl-acrylamide polymer constituted from the three monomers dirnethylacrylamide (backbone-monomer), bisacryloylethylene diamine (cross linker) and acryloylsarcosine methyl ester (functionalising agent), or can be based on polyethylene glycol (PEG), such as Rink Amide resin (e.g., NovaPEG Rink Amide). The peptide-to-resin cleavable linked agent can be the acid-labile 4-hydroxymethyl-phenoxyacetic acid derivative, or in case of C-terminal amides, the Rink-amide linker. All amino acid derivatives can be added as their preformed symmetrical anhydride derivatives with the exception of asparagine and glutamine, which are added using a reversed N,N-dicyclohexyl-carbodiimide/1-hydroxybenzotriazole mediated coupling procedure. Alternatively, other peptide coupling reagents, such as O-benzotriazole-N,N,N′,N′-tetramethyl-uronium-hexafluoro-phosphate (HBTU) or 2-(6-chloro-1-H-benzotriazole-1-yl)-1,1,3,3-tetramethylaminium haxafluorophosphate (HCTU) can be used (e.g., in situ). Coupling and deprotection reactions can be monitored using ninhydiin, trinitrobenzene sulphonic acid or isotin test procedures. Upon completion of synthesis, peptides are cleaved from the resin support with concomitant removal of side-chain protecting groups, e.g., by treatment with 95% trifluoroacetic acid containing about 5-50% scavenger. Scavengers commonly used are TIPS (triisopropylsilane), ethanedithiol, phenol, anisole water, and mixtures thereof. The exact choice depends on the constituent amino acids of the peptide being synthesised. For methionine containing peptides one can use, e.g., a mixture of TIPS (e.g., 2-5%) and ethanedithiol (e.g., 2-5%).

Trifluoroacetic acid can subsequently be removed by evaporation in vacuo, with subsequent trituration with diethyl ether affording the crude peptide. Any scavengers present can be removed by a simple extraction procedure which on lyophilisation of the aqueous phase affords the crude peptide free of scavengers.

Reagents for peptide synthesis are generally available, e.g., from Calbiochem-Novabiochem (UK), or EMD4Biosciences (U.S.).

Purification of the peptides may be effected by any one, or a combination of, techniques such as size exclusion chromatography, ion-exchange chromatography, affinity chromatography, differential solubility, and reverse-phase high performance liquid chromatography. Analysis of peptides may be carried out using thin layer chromatography, reverse-phase high performance liquid chromatography, mass spectroscopy (e.g., LC-MS), amino-acid analysis after acid hydrolysis and by fast atom bombardment (FAB) mass spectrometry.

SPOT-synthesis, which allows the positional addressable, chemical synthesis of peptides on continuous cellulose membranes may be also used (see, e.g., R. Frank, Tetrahedron (1992) 48, 9217).

The fusion compound of the present disclosure may also be produced by recombinant protein expression or in vitro translation systems (see, e.g., Sambrook et al., “Molecular cloning: A laboratory manual”, 2001, 3rd edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y.). Recombinant methods are generally preferred when the peptide is particularly large, e.g., larger than 50 amino acids, or larger than 100 amino acids. For example, the fusion compound of the present disclosure can be made recombinantly, see, e.g., procedures for FVIII-Fc expression and purification described in WO2011/069164, which is incorporated herein by reference in its entirety.

For example, the suitable expression vector or vectors are transfected or co-transfected into a suitable target cell, which will express the polypeptides. Transfection techniques known in the art include, but are not limited to, calcium phosphate precipitation (Wigler et al. (1978) Cell 14:725), electroporation (Neumann et al. (1982) EMBO J 1:841), and liposome-based reagents. A variety of host-expression vector systems may be utilized to express the proteins described herein including both prokaryotic and eukaryotic cells. These include, but are not limited to, microorganisms such as bacteria (e.g., E. coli) transformed with recombinant bacteriophage DNA or plasmid DNA expression vectors containing an appropriate coding sequence; yeast or filamentous fungi transformed with recombinant yeast or fungi expression vectors containing an appropriate coding sequence; insect cell systems infected with recombinant virus expression vectors (e.g., baculovirus) containing an appropriate coding sequence; plant cell systems infected with recombinant virus expression vectors (e.g., cauliflower mosaic virus or tobacco mosaic virus) or transformed with recombinant plasmid expression vectors (e.g., Ti plasmid) containing an appropriate coding sequence; or animal cell systems, including mammalian cells (e.g., HEK 293, CHO, Cos, HeLa, HKB11, and BHK cells).

In one embodiment, the host cell is a eukaryotic cell. As used herein, a eukaryotic cell refers to any animal or plant cell having a definitive nucleus. Eukaryotic cells of animals include cells of vertebrates, e.g., mammals, and cells of invertebrates, e.g., insects. Eukaryotic cells of plants specifically can include, without limitation, yeast cells. A eukaryotic cell is distinct from a prokaryotic cell, e.g., bacteria.

In certain embodiments, the eukaryotic cell is a mammalian cell. A mammalian cell is any cell derived from a mammal. Mammalian cells specifically include, but are not limited to, mammalian cell lines. In one embodiment, the mammalian cell is a human cell. In another embodiment, the mammalian cell is a HEK 293 cell, which is a human embryonic kidney cell line. HEK 293 cells are available as CRL-1533 from American Type Culture Collection, Manassas, Va., and as 293-H cells, Catalog No. 11631-017 or 293-F cells, Catalog No. 11625-019 from Invitrogen (Carlsbad, Calif.). In some embodiments, the mammalian cell is a PER.C6® cell, which is a human cell line derived from retina. PER.C6® cells are available from Crucell (Leiden, The Netherlands). In other embodiments, the mammalian cell is a Chinese hamster ovary (CHO) cell. CHO cells are available from American Type Culture Collection, Manassas, Va. (e.g., CHO-K1; CCL-61). In still other embodiments, the mammalian cell is a baby hamster kidney (BHK) cell. BHK cells are available from American Type Culture Collection, Manassas, Va. (e.g., CRL-1632). In some embodiments, the mammalian cell is a HKB11 cell, which is a hybrid cell line of a HEK293 cell and a human B cell line. Mei et al., Mol. Biotechnol. 34(2): 165-78 (2006).

In another example, the fusion compounds of the present disclosure can be made semi-recombinantly (see, e.g., U.S. Pat. No. 7,381,408 to Mezo, A. R. and Peters, R. P.; Dawson, P. E., Kent, S. B. Ann. Rev. Biochem. (2000) 69: 923-9600; Mei, B. et. al., Blood (2010) 116:270-279; and U.S. Patent Application Publication US2006/0115876 to Pan, C. et. al., each of which is incorporated herein in its entirety). In one example, the polypeptide or the polypeptide construct containing a suitable amino acid moiety is made recombinantly. The procoagulant compound is then attached to an immunoglobulin constant region or a portion thereof via chemical ligation as described herein.

Pharmaceutical Formulations

The invention also provides a pharmaceutical composition (also referred to as pharmaceutical formulation) containing at least one fusion compound of the present disclosure according to any of the above embodiments and a pharmaceutically acceptable carrier.

The term “pharmaceutically acceptable carrier” means all pharmaceutically acceptable ingredients known to those of skill in the art, which are typically considered non-active ingredients. The term “pharmaceutically acceptable carrier” includes, e.g., solvents, solid or liquid diluents, additives, vehicles, adjuvants, excipients, glidants, binders, granulating agents, dispersing agents, suspending agents, wetting agents, lubricating agents, disintegrants, solubilizers, stabilizers, preservatives, emulsifiers, fillers, preservatives (e.g., anti-oxidants), flavoring agents, sweetening agents, thickening agents, buffering agents, coloring agents and the like, as well as any mixtures thereof. Exemplary carriers (i.e., excipients) are described in, e.g., Handbook of Pharmaceutical Manufacturing Formulations, Volumes 1-6, Niazi, Sarfaraz K., Taylor & Francis Group 2005, which is incorporated herein by reference in its entirety. Pharmaceutical compositions may additionally comprise, for example, one or more of water, buffers (e.g., neutral buffered saline or phosphate buffered saline), ethanol, mineral oil, vegetable oil, dimethylsulfoxide, carbohydrates (e.g., glucose, mannose, sucrose or dextrans), mannitol, proteins, adjuvants, polypeptides or amino acids such as glycine, antioxidants, chelating agents such as EDTA or glutathione and/or preservatives.

Pharmaceutical compositions may be formulated for any appropriate manner of administration, including, for example, topical (e.g., transdermal or ocular), oral, buccal, nasal, vaginal, rectal or parenteral administration. In some embodiments, the fusion compound of the present disclosure is administered parenterally, e.g., intraveneously or subcutaneously.

The term parenteral as used herein includes subcutaneous, intradermal, intravascular (e.g., intravenous), intramuscular, spinal, intracranial, intrathecal, intraocular, periocular, intraorbital, intrasynovial and intraperitoneal injection, as well as any similar injection or infusion technique. It is preferred that subcutaneous, intraperitoneal, buccal, intravenous and other parenteral formulations are sterile and endotoxin free.

Fusion compounds of the present disclosure may be administered parenterally in a sterile medium. The fusion compound, depending on the vehicle and concentration used, can either be suspended or dissolved in the vehicle. In one embodiment, adjuvants such as local anesthetics, preservatives and buffering agents can be dissolved in the vehicle.

In one example, the fusion compounds of the present disclosure are administered to the subject using a non-intravenous route, e.g., by subcutaneous, nasal, buccal, oral or pulmonary delivery.

Forms suitable for oral use include, for example, tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsion, hard or soft capsules, or syrups or elixirs. Compositions provided herein may be formulated as a lyophilizate.

Compositions intended for oral use may be prepared according to any method known for the manufacture of pharmaceutical compositions. Such compositions may contain one or more agents chosen from the group consisting of sweetening agents, flavoring agents, coloring agents and preservative agents in order to provide pharmaceutically elegant and palatable preparations. Tablets can contain the active ingredient in admixture with non-toxic pharmaceutically acceptable excipients that are suitable for the manufacture of tablets. These excipients may be for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example, corn starch, or alginic acid; binding agents, for example starch, gelatin or acacia, and lubricating agents, for example magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques. In some cases such coatings may be prepared by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period (i.e., tablets can be enterically coated). For example, a time delay material such as glyceryl monosterate or glyceryl distearate may be employed.

Formulations for oral use may also be presented as hard gelatin capsules, wherein the active ingredient is mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, for example peanut oil, liquid paraffin or olive oil. In another example, the active ingredient is formulated in capsules containing optionally coated microtablets or micropellets. Formulations for oral use may also be presented as lozenges. The composition can be also for example a suspension, emulsion, sustained release formulation, cream, gel or powder. The composition can be formulated as a suppository, with traditional binders and carriers such as triglycerides.

Oily suspensions may be formulated by suspending the active ingredients in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin. The oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents and flavoring agents may be added to provide palatable oral preparations. These compositions may be preserved by the addition of an anti-oxidant such as ascorbic acid.

In one example, the pharmaceutical formulation is a liquid formulation, e.g., a buffered, isotonic, aqueous solution. In one example, the pharmaceutical composition has a pH that is physiologic, or close to physiologic. In another example, the aqueous formulation has a physiologic or close to physiologic osmolarity and salinity. It can contain sodium chloride and/or sodium acetate.

In another example, the pharmaceutical formulation further contains a blood coagulation factor selected from FVIII and FIX. In another example, the pharmaceutical formulation further includes FVIII. In another example, the pharmaceutical formulation further includes FIX. In another example, the pharmaceutical formulation includes desmopressin (DDVAP).

Methods

The invention further provides a method (e.g., an in vitro or an in vivo method) of increasing/enhancing the catalytic activity (kcat) of a blood coagulation factor (i.e., activating the blood coagulation factor). An exemplary method includes contacting the blood coagulation factor (e.g., FIXa or FVIIa) with a fusion compound of the present disclosure according to any of the above embodiments. In one example, the blood coagulation factor useful in this method includes the amino acid sequence: MFCAG (SEQ ID NO: 6) (e.g., FIXa, FXa, FVIIa and thrombin). In one example, the blood coagulation factor being activated is FXa. In another example, the blood coagulation factor being activated is thrombin.

The invention further provides a method of increasing/enhancing the catalytic activity (kcat) of FIXa (e.g., in vitro or in vivo), the method includes contacting the FIXa with a compound of the present disclosure according to any of the above embodiments.

The invention further provides a method of increasing/enhancing the catalytic activity (kcat) of FVIIa (e.g., in vitro or in vivo), the method includes contacting the FVIIa with a compound of the present disclosure according to any of the above embodiments.

In one example according to the above method, the compound interacts with the blood coagulation factor (e.g., binds to the blood coagulation factor) at a region corresponding to amino acid sequence: MFCAG (SEQ ID NO: 6).

In a further example, the blood coagulation factor being activated is FIXa (e.g., human or canine FIXa). In one example according to this embodiment, the compound of the present disclosure interacts with the FIXa at a region corresponding to amino acid sequence: YNNMFCAGFHE (SEQ ID NO: 30). In yet another example, the compound of the present disclosure interacts with the FIXa at a region corresponding to amino acid sequence: RSTKFTIYNNMFCAGFHEGGRDSCQG (SEQ ID NO: 31).

In another example according to any of the above embodiments, the method is an in vitro method involving measuring conversion of FX to FXa. Such method is also generally referred to as a “FXa generation assay”.

In one embodiment the fusion compound is used in an in vitro assay system useful for the identification of other candidate compounds with procoagulant activity (e.g., a competition assay). In one example, the fusion compound of the present disclosure is used as a reference compound in such assay system. In another example, the fusion compound is used in a binding competition experiment as a probe. In one example, the fusion compound of the present disclosure is used as a probe to measure binding of a candidate compound to a polypeptide (e.g., FIXa, FVIIa, or peptide including the amino acid sequences of SEQ ID NO: 8, 10, 12, 14, 16, 18-21, and 32). For this purpose, the fusion compound of the present disclosure can be linked to a detection molecule, such as an antibody (e.g., ELISA assay), biotin, a fluorescent molecule, a phage particle (e.g., phage display competition assay), and the like.

Pharmaceutical Methods

The present invention further provides methods for treating bleeding diathesis in a mammalian subject (e.g., a human patient) using the fusion compound or the present disclosure.

In some embodiments, the present disclosure provides a method for treating a coagulation disorder in a mammalian subject (e.g., a human patient) having a deficiency in at least one blood coagulation factor selected from von Willebrand Factor (vWF), FV, FVII, FVIII, FIX, FX, FXI, and activated forms thereof (e.g., for both the prophylaxis and for the treatment of acute bleeds), the method comprising: administering to the subject in need thereof a therapeutically effective amount of a fusion compound of the present disclosure or a pharmaceutical composition comprising a fusion compound of the present disclosure.

In some embodiments, the present disclosure provides a method for treating bleeding diathesis in a mammalian subject (e.g., a human patient), comprising: administering to the subject in need thereof a therapeutically effective amount of a fusion compound of the present disclosure or a pharmaceutical composition comprising a fusion compound of the present disclosure.

In some embodiments of pharmaceutical method 1, the fusion compound containing the compound is administered to the subject orally. In other embodiments, the fusion compound or the pharmaceutical composition containing the fusion compound is administered to the subject parenterally, e.g., intravenously or subcutaneously.

In one example according to any of the above embodiments of pharmaceutical methods 1 and 2, the bleeding diathesis is caused by or associated with a blood coagulation disorder. A blood coagulation disorder can also be referred to as a coagulopathy. In a particular example, the blood coagulation disorder, which can be treated with a fusion compound of the current disclosure, is hemophilia or von Willebrand disease (vWD). In a particular example, the blood coagulation disorder, which can be treated is hemophilia. In another example, the hemophilia is hemophilia A. In yet another example, the hemophilia is hemophilia B.

In another example, the type of bleeding associated with the bleeding diathesis is selected from hemarthrosis, muscle bleed, oral bleed, hemorrhage, hemorrhage into muscles, oral hemorrhage, trauma, trauma capitis, gastrointestinal bleeding, intracranial hemorrhage, intra-abdominal hemorrhage, intrathoracic hemorrhage, bone fracture, central nervous system bleeding, bleeding in the retropharyngeal space, bleeding in the retroperitoneal space, and bleeding in the illiopsoas sheath.

In another example, the subject suffering from bleeding diathesis is in need of treatment for surgery, including, e.g., surgical prophylaxis or peri-operative management. In one example, the surgery is selected from minor surgery and major surgery. Exemplary surgical procedures include tooth extraction, tonsillectomy, inguinal herniotomy, synovectomy, craniotomy, osteosynthesis, trauma surgery, intracranial surgery, intra-abdominal surgery, intrathoracic surgery, joint replacement surgery (e.g., total knee replacement, hip replacement, and the like), heart surgery, and caesarean section.

In some embodiments, the coagulation disorder is caused by a deficiency in at least one blood coagulation factor (e.g., FVIII). The current disclosure provides methods of treating a mammalian subject (e.g., a human subject) having a deficiency in at least one blood coagulation factor selected from von Willebrand Factor (vWF), FV, FVII, FVIII, FIX, FX, FXI, and activated forms thereof (e.g., for both the prophylaxis and for the treatment of acute bleeds).

In some embodiments, the current disclosure provides a method of treating a mammalian subject (e.g., a human subject) having a deficiency in FVIII, the method includes administering to the subject a therapeutically effective amount of a fusion compound of the current disclosure or a pharmaceutical composition containing a fusion compound of the current disclosure.

Patients with a FVIII deficiency (i.e., hemophilia A) can develop inhibitor antibodies to FVIII. The biological activity of certain compounds or conjugates of the present disclosure is essentially not influenced by the presence of FVIII inhibitors, such as antibodies against FVIII. Hence, in one example according to any of the above embodiments of pharmaceutical methods 1-6, the mammalian subject (e.g., a human patient) suffering from a FVIII deficiency is a FVIII inhibitor patient (e.g., produces antibodies against FVIII). The magnitude of the antibody response to FVIII can be quantified using a functional inhibitor assay, such as that described in Kasper C K et al. (1975) Proceedings: A more uniform measurement of factor VIII inhibitors. Thromb. Diath. Haemorrh. 34(2):612. FXI inhibitors could be quantified by an aPTT assay as described by Kasper C K et al., Inhibitors of FV, FVII and FX could be quantified by a PT based assay following the procedure of Kasper C K et al.

Inhibitor development (to FIX) is also known in FIX deficiency (i.e., hemophilia B). The biological activity (e.g., FXa generation assay activity) of certain compounds of the present disclosure is essentially not influenced by the presence of FIX inhibitors, such as antibodies against FIX. Since FV, FVII, FXI and FX deficiencies are very rare congenital disorders little is known about inhibitor development, although it is feasible that patients having such disorders might develop inhibitors. Treatment of inhibitor patients is contemplated by the current invention. Such inhibitor patients may have either a high titer response of greater than 5 BU or a low titer response of between 0.5 and 5 BU. Typically, the inhibitors are directed against FVIII and the patients have hemophilia A.

In another example, the mammalian subject (e.g., human patient) is concomitantly treated with FIX. Because the fusion compound of the invention are capable of activating FIXa, they could be used to pre-activate the FIXa polypeptide before administration of the FIXa to the subject.

In yet another example, the mammalian subject (e.g., human subject) is concomitantly treated with desmopressin (DDVAP).

The methods of the invention may be practiced on a subject in need of prophylactic treatment or on-demand treatment.

In various embodiments, the fusion compound of the present disclosure can be used as a replacement therapy (e.g., replacing FVIII treatment) in subjects in need of treatment for hemophilia A. In other embodiments, the fusion compound of the present disclosure can be used in conjunction with other therapies (e.g., FVIII or FIX therapy) in subjects in need of treatment for hemophilia A or B. In other embodiments, the compounds of the present disclosure are useful as a bypass therapy in subjects in need of treatment for hemophilia A (e.g., hemophilia A patients with inhibitors).

Administration of Fusion Compound

The calculation of the required dosage for the fusion compound of the present disclosure is based upon the empirical finding that, on average, 1 IU of FVIII per kg body weight raises the plasma FVIII activity by approximately 2 IU/dL. The required dosage is determined using the following formula:

Required units=body weight (kg)×desired FVIII rise (IU/dL or % of normal)×0.5 (IU/kg per IU/dL).

It will be understood, however, that the specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, route of administration, and rate of excretion, drug combination and the severity of the particular disease undergoing therapy.

Dosage levels of the order of from about 0.005 mg to about 80 mg per kilogram of body weight per day are useful in the treatment of the diseases and conditions described herein (e.g., about 0.35 mg to about 5.6 g per human patient per day, based on an average adult person weight of 70 kg). The amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. Dosage unit forms will generally contain between from about 1 mg to about 500 mg of an active ingredient. The daily dose can be administered in one to four doses per day. In the case of skin conditions, it may, for example, be applied as a topical preparation of compounds of this present disclosure on the affected area one to four times a day.

It will be understood, however, that the specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, route of administration, and rate of excretion, drug combination and the severity of the particular disease undergoing therapy.

Having now described the present invention in detail, the same will be more clearly understood by reference to the following examples, which are included herewith for purposes of illustration only and are not intended to be limiting of the invention. All patents and publications referred to herein are expressly incorporated by reference.

EXAMPLES

Throughout the examples, the following materials and methods were used unless otherwise stated.

Materials and Methods

In general, the practice of the present invention employs, unless otherwise indicated, conventional techniques of chemistry, biophysics, molecular biology, recombinant DNA technology, immunology (especially, e.g., antibody technology), and standard techniques in electrophoresis. See, e.g., Sambrook, Fritsch and Maniatis, Molecular Cloning: Cold Spring Harbor Laboratory Press (1989); Antibody Engineering Protocols (Methods in Molecular Biology), 510, Paul, S., Humana Pr (1996); Antibody Engineering: A Practical Approach (Practical Approach Series, 169), McCafferty, Ed., Irl Pr (1996); Antibodies: A Laboratory Manual, Harlow et al., CS.H.L. Press, Pub. (1999); and Current Protocols in Molecular Biology, eds. Ausubel et al., John Wiley & Sons (1992).

Example 1 Expression of pSYN-Fc-048

Cloning of pSYN-Fc-048 was performed using Rapid DNA Ligation Kit from Roche Diagnostics (cat #11635379001) following manufacturer's guidelines. Briefly, 10-50 ng of vector or fragment DNA was added to a final volume of 10 μL ligation mixture containing 1× Rapid DNA Ligation buffer and 1 μL Rapid DNA Ligase. The reaction was allowed to proceed for 5-30 min at room temperature and placed on ice. 2 μL of the ligation reaction was transformed in 25 μL Mach 1 E. coli competent cells from Invitrogen (cat #C869601) and plated on an appropriate antibiotic for selection.

The 1.7 kb DNA fragment comprising the region from HindIII to EcoRI of pSYN-Fc-048 was synthesized and subcloned into the HindIII/EcoRI sites of pcDNA4MycHisA vector (Invitrogen) to generate pSYN-Fc-048.

For expression of Fc-048, HEK-293-F cells were grown in suspension in Freestyle media (Invitrogen) to 2 μg/liter (growth media) as suspension cells at 37° C./10% CO₂. Cells were subcultured every three to four days by seeding at cell density of 5×10⁵ cells/mL.

Twenty-four hours prior to transfection, cells were seeded at a density of 7×10⁵ cells/mL in growth media. On the day of transfection, a transfection solution was made with a volume equal to 5% of the total volume of the cell culture to be transfected. In the transfection solution, DNA was added (final concentration 20 mg/L) to a freshly made solution of PEI (60 mg/L) in growth media. The solution was swirled for 30 seconds and incubated for five minutes at room temperature before adding it directly to the cell culture. Four hours later a volume equal to the cell culture volume of OptiCHO (Invitrogen) supplemented 200 mM L-glutamine was added to the cells. The cell culture was allowed to grow as shown above and daily media samples were taken to assess protein expression. On the day of harvest, the cells were spun down and the media filtered in preparation for protein purification or protein analysis by FcRn pulldown.

DNA sequence of pSYN-Fc-048 (SEQ ID NO: 1): 1 AGCTTGCCGC CACCATGGAG ACAGACACAC TCCTGCTATG GGTACTGCTG CTCTGGGTTC CAGGTTCCAC 71 TGGTGGCAGT CGGATTCGGA CAGTGAGCCC CGGCAGCCGG AGCGCCAGCG GCAAGAGTAC CTGCCTGGCC 141 AGCTACTGCT GGCTGTTCTG GACCGGCATC GCCGGTGGCG GTGGATCCGG CGGAGGTGGG TCCGGTGGCG 211 GCGGATCAGG TGGGGGTGGA TCAGGCGGTG GAGGTTCCGG TGGCGGGGGA TCAGACAAAA CTCACACATG 281 CCCACCGTGC CCAGCTCCGG AACTCCTGGG CGGACCGTCA GTCTTCCTCT TCCCCCCAAA ACCCAAGGAC 351 ACCCTCATGA TCTCCCGGAC CCCTGAGGTC ACATGCGTGG TGGTGGACGT GAGCCACGAA GACCCTGAGG 421 TCAAGTTCAA CTGGTACGTG GACGGCGTGG AGGTGCATAA TGCCAAGACA AAGCCGCGGG AGGAGCAGTA 491 CAACAGCACG TACCGTGTGG TCAGCGTCCT CACCGTCCTG CACCAGGACT GGCTGAATGG CAAGGAGTAC 561 AAGTGCAAGG TCTCCAACAA AGCCCTCCCA GCCCCCATCG AGAAAACCAT CTCCAAAGCC AAAGGGCAGC 631 CCCGAGAACC ACAGGTGTAC ACCCTGCCCC CATCCCGGGA TGAGCTGACC AAGAACCAGG TCAGCCTGAC 701 CTGCCTGGTC AAAGGCTTCT ATCCCAGCGA CATCGCCGTG GAGTGGGAGA GCAATGGGCA GCCGGAGAAC 771 AACTACAAGA CCACGCCTCC CGTGTTGGAC TCCGACGGCT CCTTCTTCCT CTACAGCAAG CTCACCGTGG 841 ACAAGAGCAG GTGGCAGCAG GGGAACGTCT TCTCATGCTC CGTGATGCAT GAGGCTCTGC ACAACCACTA 911 CACGCAGAAG AGCCTCTCCC TGTCTCCGGG TAAAGGTGGC GGCGGATCAG GTGGGGGTGG ATCAGGCGGT 981 GGAGGTTCCG GTGGCGGGGG ATCAGACAAA ACTCACACAT GCCCACCGTG CCCAGCACCT GAACTCCTGG 1051 GAGGACCGTC AGTCTTCCTC TTCCCCCCAA AACCCAAGGA CACCCTCATG ATCTCCCGGA CCCCTGAGGT 1121 CACATGCGTG GTGGTGGACG TGAGCCACGA AGACCCTGAG GTCAAGTTCA ACTGGTACGT GGACGGCGTG 1191 GAGGTGCATA ATGCCAAGAC AAAGCCGCGG GAGGAGCAGT ACAACAGCAC GTACCGTGTG GTCAGCGTCC 1261 TCACCGTCCT GCACCAGGAC TGGCTGAATG GCAAGGAGTA CAAGTGCAAG GTCTCCAACA AAGCCCTCCC 1331 AGCCCCCATC GAGAAAACCA TCTCCAAAGC CAAAGGGCAG CCCCGAGAAC CACAGGTGTA CACCCTGCCC 1401 CCATCCCGCG ATGAGCTGAC CAAGAACCAG GTCAGCCTGA CCTGCCTGGT CAAAGGCTTC TATCCCAGCG 1471 ACATCGCCGT GGAGTGGGAG AGCAATGGGC AGCCGGAGAA CAACTACAAG ACCACGCCTC CCGTGTTGGA 1541 CTCCGACGGC TCCTTCTTCC TCTACAGCAA GCTCACCGTG GACAAGAGCA GGTGGCAGCA GGGGAACGTC 1611 TTCTCATGCT CCGTGATGCA TGAGGCTCTG CACAACCACT ACACGCAGAA GAGCCTCTCC CTGTCTCCGG 1681 GTAAATGAGA ATTCTGCAGA TATCCAGCAC AGTGGCGGCC GCTCGAGTCT AGAGGGCCCT TCGAACAAAA 1751 ACTCATCTCA GAAGAGGATC TGAATATGCA TACCGGTCAT CATCACCATC ACCATTGAGT TTAAACCCGC 1821 TGATCAGCCT CGACTGTGCC TTCTAGTTGC CAGCCATCTG TTGTTTGCCC CTCCCCCGTG CCTTCCTTGA 1891 CCCTGGAAGG TGCCACTCCC ACTGTCCTTT CCTAATAAAA TGAGGAAATT GCATCGCATT GTCTGAGTAG 1961 GTGTCATTCT ATTCTGGGGG GTGGGGTGGG GCAGGACAGC AAGGGGGAGG ATTGGGAAGA CAATAGCAGG 2031 CATGCTGGGG ATGCGGTGGG CTCTATGGCT TCTGAGGCGG AAAGAACCAG CTGGGGCTCT AGGGGGTATC 2101 CCCACGCGCC CTGTAGCGGC GCATTAAGCG CGGCGGGTGT GGTGGTTACG CGCAGCGTGA CCGCTACACT 2171 TGCCAGCGCC CTAGCGCCCG CTCCTTTCGC TTTCTTCCCT TCCTTTCTCG CCACGTTCGC CGGCTTTCCC 2241 CGTCAAGCTC TAAATCGGGG GCTCCCTTTA GGGTTCCGAT TTAGTGCTTT ACGGCACCTC GACCCCAAAA 2311 AACTTGATTA GGGTGATGGT TCACGTAGTG GGCCATCGCC CTGATAGACG GTTTTTCGCC CTTTGACGTT 2381 GGAGTCCACG TTCTTTAATA GTGGACTCTT GTTCCAAACT GGAACAACAC TCAACCCTAT CTCGGTCTAT 2451 TCTTTTGATT TATAAGGGAT TTTGGGGATT TCGGCCTATT GGTTAAAAAA TGAGCTGATT TAACAAAAAT 2521 TTAACGCGAA TTAATTCTGT GGAATGTGTG TCAGTTAGGG TGTGGAAAGT CCCCAGGCTC CCCAGGCAGG 2591 CAGAAGTATG CAAAGCATGC ATCTCAATTA GTCAGCAACC AGGTGTGGAA AGTCCCCAGG CTCCCCAGCA 2661 GGCAGAAGTA TGCAAAGCAT GCATCTCAAT TAGTCAGCAA CCATAGTCCC GCCCCTAACT CCGCCCATCC 2731 CGCCCCTAAC TCCGCCCAGT TCCGCCCATT CTCCGCCCCA TGGCTGACTA ATTTTTTTTA TTTATGCAGA 2801 GGCCGAGGCC GCCTCTGCCT CTGAGCTATT CCAGAAGTAG TGAGGAGGCT TTTTTGGAGG CCTAGGCTTT 2871 TGCAAAAAGC TCCCGGGAGC TTGTATATCC ATTTTCGGAT CTGATCAGCA CGTGTTGACA ATTAATCATC 2941 GGCATAGTAT ATCGGCATAG TATAATACGA CAAGGTGAGG AACTAAACCA TGGCCAAGTT GACCAGTGCC 3011 GTTCCGGTGC TCACCGCGCG CGACGTCGCC GGAGCGGTCG AGTTCTGGAC CGACCGGCTC GGGTTCTCCC 3081 GGGACTTCGT GGAGGACGAC TTCGCCGGTG TGGTCCGGGA CGACGTGACC CTGTTCATCA GCGCGGTCCA 3151 GGACCAGGTG GTGCCGGACA ACACCCTGGC CTGGGTGTGG GTGCGCGGCC TGGACGAGCT GTACGCCGAG 3221 TGGTCGGAGG TCGTGTCCAC GAACTTCCGG GACGCCTCCG GGCCGGCCAT GACCGAGATC GGCGAGCAGC 3291 CGTGGGGGCG GGAGTTCGCC CTGCGCGACC CGGCCGGCAA CTGCGTGCAC TTCGTGGCCG AGGAGCAGGA 3361 CTGACACGTG CTACGAGATT TCGATTCCAC CGCCGCCTTC TATGAAAGGT TGGGCTTCGG AATCGTTTTC 3431 CGGGACGCCG GCTGGATGAT CCTCCAGCGC GGGGATCTCA TGCTGGAGTT CTTCGCCCAC CCCAACTTGT 3501 TTATTGCAGC TTATAATGGT TACAAATAAA GCAATAGCAT CACAAATTTC ACAAATAAAG CATTTTTTTC 3571 ACTGCATTCT AGTTGTGGTT TGTCCAAACT CATCAATGTA TCTTATCATG TCTGTATACC GTCGACCTCT 3641 AGCTAGAGCT TGGCGTAATC ATGGTCATAG CTGTTTCCTG TGTGAAATTG TTATCCGCTC ACAATTCCAC 3711 ACAACATACG AGCCGGAAGC ATAAAGTGTA AAGCCTGGGG TGCCTAATGA GTGAGCTAAC TCACATTAAT 3781 TGCGTTGCGC TCACTGCCCG CTTTCCAGTC GGGAAACCTG TCGTGCCAGC TGCATTAATG AATCGGCCAA 3851 CGCGCGGGGA GAGGCGGTTT GCGTATTGGG CGCTCTTCCG CTTCCTCGCT CACTGACTCG CTGCGCTCGG 3921 TCGTTCGGCT GCGGCGAGCG GTATCAGCTC ACTCAAAGGC GGTAATACGG TTATCCACAG AATCAGGGGA 3991 TAACGCAGGA AAGAACATGT GAGCAAAAGG CCAGCAAAAG GCCAGGAACC GTAAAAAGGC CGCGTTGCTG 4061 GCGTTTTTCC ATAGGCTCCG CCCCCCTGAC GAGCATCACA AAAATCGACG CTCAAGTCAG AGGTGGCGAA 4131 ACCCGACAGG ACTATAAAGA TACCAGGCGT TTCCCCCTGG AAGCTCCCTC GTGCGCTCTC CTGTTCCGAC 4201 CCTGCCGCTT ACCGGATACC TGTCCGCCTT TCTCCCTTCG GGAAGCGTGG CGCTTTCTCA ATGCTCACGC 4271 TGTAGGTATC TCAGTTCGGT GTAGGTCGTT CGCTCCAAGC TGGGCTGTGT GCACGAACCC CCCGTTCAGC 4341 CCGACCGCTG CGCCTTATCC GGTAACTATC GTCTTGAGTC CAACCCGGTA AGACACGACT TATCGCCACT 4411 GGCAGCAGCC ACTGGTAACA GGATTAGCAG AGCGAGGTAT GTAGGCGGTG CTACAGAGTT CTTGAAGTGG 4481 TGGCCTAACT ACGGCTACAC TAGAAGGACA GTATTTGGTA TCTGCGCTCT GCTGAAGCCA GTTACCTTCG 4551 GAAAAAGAGT TGGTAGCTCT TGATCCGGCA AACAAACCAC CGCTGGTAGC GGTGGTTTTT TTGTTTGCAA 4621 GCAGCAGATT ACGCGCAGAA AAAAAGGATC TCAAGAAGAT CCTTTGATCT TTTCTACGGG GTCTGACGCT 4691 CAGTGGAACG AAAACTCACG TTAAGGGATT TTGGTCATGA GATTATCAAA AAGGATCTTC ACCTAGATCC 4761 TTTTAAATTA AAAATGAAGT TTTAAATCAA TCTAAAGTAT ATATGAGTAA ACTTGGTCTG ACAGTTACCA 4831 ATGCTTAATC AGTGAGGCAC CTATCTCAGC GATCTGTCTA TTTCGTTCAT CCATAGTTGC CTGACTCCCC 4901 GTCGTGTAGA TAACTACGAT ACGGGAGGGC TTACCATCTG GCCCCAGTGC TGCAATGATA CCGCGAGACC 4971 CACGCTCACC GGCTCCAGAT TTATCAGCAA TAAACCAGCC AGCCGGAAGG GCCGAGCGCA GAAGTGGTCC 5041 TGCAACTTTA TCCGCCTCCA TCCAGTCTAT TAATTGTTGC CGGGAAGCTA GAGTAAGTAG TTCGCCAGTT 5111 AATAGTTTGC GCAACGTTGT TGCCATTGCT ACAGGCATCG TGGTGTCACG CTCGTCGTTT GGTATGGCTT 5181 CATTCAGCTC CGGTTCCCAA CGATCAAGGC GAGTTACATG ATCCCCCATG TTGTGCAAAA AAGCGGTTAG 5251 CTCCTTCGGT CCTCCGATCG TTGTCAGAAG TAAGTTGGCC GCAGTGTTAT CACTCATGGT TATGGCAGCA 5321 CTGCATAATT CTCTTACTGT CATGCCATCC GTAAGATGCT TTTCTGTGAC TGGTGAGTAC TCAACCAAGT 5391 CATTCTGAGA ATAGTGTATG CGGCGACCGA GTTGCTCTTG CCCGGCGTCA ATACGGGATA ATACCGCGCC 5461 ACATAGCAGA ACTTTAAAAG TGCTCATCAT TGGAAAACGT TCTTCGGGGC GAAAACTCTC AAGGATCTTA 5531 CCGCTGTTGA GATCCAGTTC GATGTAACCC ACTCGTGCAC CCAACTGATC TTCAGCATCT TTTACTTTCA 5601 CCAGCGTTTC TGGGTGAGCA AAAACAGGAA GGCAAAATGC CGCAAAAAAG GGAATAAGGG CGACACGGAA 5671 ATGTTGAATA CTCATACTCT TCCTTTTTCA ATATTATTGA AGCATTTATC AGGGTTATTG TCTCATGAGC 5741 GGATACATAT TTGAATGTAT TTAGAAAAAT AAACAAATAG GGGTTCCGCG CACATTTCCC CGAAAAGTGC 5811 CACCTGACGT CGACGGATCG GGAGATCTCC CGATCCCCTA TGGTCGACTC TCAGTACAAT CTGCTCTGAT 5881 GCCGCATAGT TAAGCCAGTA TCTGCTCCCT GCTTGTGTGT TGGAGGTCGC TGAGTAGTGC GCGAGCAAAA 5951 TTTAAGCTAC AACAAGGCAA GGCTTGACCG ACAATTGCAT GAAGAATCTG CTTAGGGTTA GGCGTTTTGC 6021 GCTGCTTCGC GATGTACGGG CCAGATATAC GCGTTGACAT TGATTATTGA CTAGTTATTA ATAGTAATCA 6091 ATTACGGGGT CATTAGTTCA TAGCCCATAT ATGGAGTTCC GCGTTACATA ACTTACGGTA AATGGCCCGC 6161 CTGGCTGACC GCCCAACGAC CCCCGCCCAT TGACGTCAAT AATGACGTAT GTTCCCATAG TAACGCCAAT 6231 AGGGACTTTC CATTGACGTC AATGGGTGGA CTATTTACGG TAAACTGCCC ACTTGGCAGT ACATCAAGTG 6301 TATCATATGC CAAGTACGCC CCCTATTGAC GTCAATGACG GTAAATGGCC CGCCTGGCAT TATGCCCAGT 6371 ACATGACCTT ATGGGACTTT CCTACTTGGC AGTACATCTA CGTATTAGTC ATCGCTATTA CCATGGTGAT 6441 GCGGTTTTGG CAGTACATCA ATGGGCGTGG ATAGCGGTTT GACTCACGGG GATTTCCAAG TCTCCACCCC 6511 ATTGACGTCA ATGGGAGTTT GTTTTGGCAC CAAAATCAAC GGGACTTTCC AAAATGTCGT AACAACTCCG 6581 CCCCATTGAC GCAAATGGGC GGTAGGCGTG TACGGTGGGA GGTCTATATA AGCAGAGCTC TCTGGCTAAC 6651 TAGAGAACCC ACTGCTTACT GGCTTATCGA AATTAATACG ACTCACTATA GGGAGACCCA AGCTGGCTAG 6721 TTA

Example 2 Purification and Analysis of pSYN-Fc-048 FcRn Affinity Purification

6 mL of FcRn resin was packed into a column and equilibrated with equilibration buffer (50 mM MES, 100 mM NaCl pH 6.2). The pH of about 1500 mL media containing Fc-048 was adjusted to 6.2 by adding 0.5M MES pH 5.5 prior to loading the compound onto the column. The column was washed with two column volumes of equilibration buffer followed by twenty column volumes of wash buffer (50 mM MES pH 6.2). Fc-048 was eluted from the column using a step elution of 100% elution buffer (10 mM Tris, 250 mM NaCl pH 8.0). Fractions were analyzed by gel electrophoresis, analytical size-exclusion chromatography and UV-Vis spectrophotometry.

Size Exclusionary Chromatography (SEC) to Separate Monomer

Monomeric Fc-048 was separated from aggregates by size-exclusion chromatography using a silica-based TSKgel G3000SWx1 column with 5 μm particles and 250 Å pores from Tosoh Bioscience. The running buffer was composed of a phosphate buffered saline solution containing 250 mM sodium chloride and the absorbance was measured. Fractions were collected and concentrated through 30K 15 mL Amicon filters at 3000 rpm centrifugation. The monomer remained monomeric during the concentration step. Analytical SEC spectra of isolated monomeric, medium, and large aggregate Fc-048 can be seen in FIG. 2.

Thrombin Generation Assay (TGA)

A thrombogram was generated for the compounds of the present disclosure in order to assess the thrombin potential in a physiological plasma environment. The TGA assay was carried out using a Calibrated Automated Thrombogram (CAT) test in severe hemophilia A patient plasma from HRF (Raleigh, N.C., US). Briefly, dilutions of test compounds or controls such as FVIII were prepared in PBS (—Ca, —Mg) or directly in the FVIII-deficient patient plasma. In a 96-well round bottom plate, 20 μl of activator solution (PPP Low reagent [final 1 pM rTF, 4 μM phospholipids], Thrombinoscope bv) was added to each sample well and 20 μl of Thrombin calibrator (Thrombinoscope bv) was added to calibrator well. Subsequently, 80 μl of blank plasma was added to the calibrator well and 80 μl of plasma containing compounds of the present disclosure, controls such as FVIII or blank was added to sample wells. All samples were prepared in duplicates and the plate was incubated at 37° C. for 10 minutes. After the incubation, 20 μl of Fluca solution (Ca²⁺, fluorogenic substrate, Diagnostica Stago) was added to each well and fluorescence was measured in a microtiter plate fluorometer (Fluroskan Ascent, Thermo Scientific, Thrombinoscope software) for 1 hr. A TGA profile of Fc-048 containing a mixture of monomer and aggregates can be seen in FIG. 3A. A TGA profile of isolated monomeric and aggregate Fc-048 can be seen in FIG. 4.

In Fc-048, the procoagulant peptide has a free N-terminus. Fc-050 is a linker capped analog of Fc-048 (see FIG. 1B), which has the N-terminal of the procoagulant peptide linked to a second Fc region. A TGA profile of Fc-050 can be seen in FIG. 3B.

Additional bleeding and thrombogenicity models can be used such as described in Tranholm, M, et al, Blood 2003, 102, 3615-3620; Tranholm, M, et al, Thrombosis Research 2003, 109, 217-223; Lauritzen, B, et al, Journal of Thrombosis and Hemostasis 2009, 7, 651-657.

Example 3 Pharmacokinetic Assessment of Monomeric Fc-048

Hemophilia A mice were treated with monomeric procoagulant fusion construct, Fc-048, intravenously at a dose of 1.15 mg/kg. The hemophilia A mice used for this study are FVIII deficient mice (B6; 129S-F8tm1Kaz/J, HemA). See also Bi L. et al., Nat Genet. 10(1):119-121 (1995). Blood samples were taken from the animal via retro-orbital bleeding at the following timepoint post-dose: 5 minutes, 6 hours, 24 hours, 48 hours, 72 hours, 96 hours, and 144 hours. Plasma concentrations of procoagulant fusion construct Fc-048 were determined using anti-human Fc-Fc ELISA. A diagram showing the plasma levels of Fc-048 (expressed as percentages of initial dose) over the course of 6 days can be seen in FIG. 5. Each data point is based on analysis of blood samples from 4 mice.

Pharmacokinetic parameters were calculated according to standard methods used in the art. The results are shown below:

Cmax/dose: 0.0215 kg/mL;

Recovery: 84%; Alpha-t_(1/2): 2.1 h; Beta-t_(1/2): 131.5 h;

AUC/dose: 1.95 h*kg/mL; Cl: 0.512 mL/h/kg; V_(ss): 95.4 mL/kg.

In summary, the Fc fusion construct improved the pharmacokinetic properties in hemophilia A mice. Monomeric Fc-048 was found to have prolonged half-life in hemophilia A mice compared to the parent peptide.

Having now fully described this invention, it will be understood by those of ordinary skill in the art that the same can be performed within a wide and equivalent range of conditions, formulations and other parameters without affecting the scope of the invention or any embodiment thereof.

Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.

All patents and publications cited herein are incorporated by reference herein in their entirety.

The present application claims the benefit of U.S. Provisional Application No. 61/901,973, filed Nov. 8, 2013 and U.S. Provisional Application No. 61/981,446, filed Apr. 18, 2014, which are incorporated herein by reference in their entireties.

TABLE 1 Polynucleotide Sequences: FIX-Fc A. FIX-Fc Chain DNA Sequence (SEQ ID NO: 7, which encodes SEQ ID NO: 8) pSYN-FIX-030 Nucleotide sequence (nt 1 to 7583): FIX exon 1 (signal peptide, 1st amino acid propeptide): nt 690-777 FIX mini intron: nt 778-1076 FIX propeptide sequence: nt 1077-1126 Mature FIX sequence: nt 1127-2371 Fc: nt 2372-3052 gcgcgcgttgacattgattattgactagttattaatagtaatcaattacggggtcattagttcatagcccatatatgg agttccgcgttacataacttacggtaaatggcccgcctggctgaccgcccaacgacccccgcccattgacgtcaataa tgacgtatgttcccatagtaacgccaatagggactttccattgacgtcaatgggtggagtatttacggtaaactgccc acttggcagtacatcaagtgtatcatatgccaagtacgccccctattgacgtcaatgacggtaaatggcccgcctggc attatgcccagtacatgaccttatgggactttcctacttggcagtacatctacgtattagtcatcgctattaccatgg tgatgcggttttggcagtacatcaatgggcgtggatagcggtttgactcacggggatttccaagtctccaccccattg acgtcaatgggagtttgttttggcaccaaaatcaacgggactttccaaaatgtcgtaacaactccgccccattgacgc aaatgggcggtaggcgtgtacggtgggaggtctatataagcagagctctctggctaactagagaacccactgcttact ggcttatcgaaattaatacgactcactatagggagacccaagcttcgcgacgtacggccgccaccatgcagcgcgtga acatgatcatggcagaatcaccaggcctcatcaccatctgccttttaggatatctactcagtgctgaatgtacaggtt tgtttccttttttaaaatacattgagtatgcttgccttttagatatagaaatatctgatgctgtcttcttcactaaat tttgattacatgatttgacagcaatattgaagagtctaacagccagcacgcaggttggtaagtactgtgggaacatca cagattttggctccatgccctaaagagaaattggctttcagattatttggattaaaaacaaagactttcttaagagat gtaaaattttcatgatgttttcttttttgctaaaactaaagaattattcttttacatttcagtttttcttgatcatga aaacgccaacaaaattctgaatcggccaaagaggtataattcaggtaaattggaagagtttgttcaagggaatctaga gagagaatgtatggaagaaaagtgtagttttgaagaagcacgagaagtttttgaaaacactgaaagaacaactgaatt ttggaagcagtatgttgatgaagatcagtgtgagtccaatccatgtttaaatggcggcagttgcaaggatgacattaa ttcctatgaatgttggtgtccctttggatttgaaggaaagaactgtgaattagatgtaacatgtaacattaagaatgg cagatgcgagcagttttgtaaaaatagtgctgataacaaggtggtttgctcctgtactgagggatatcgacttgcaga aaaccagaagtcctgtgaaccagcagtgccatttccatgtggaagagtttctgtttcacaaacttctaagctcacccg tgctgagactgtttttcctgatgtggactatgtaaattctactgaagctgaaaccattttggataacatcactcaaag cacccaatcatttaatgacttcactcgggttgttggtggagaagatgccaaaccaggtcaattcccttggcaggttgt tttgaatggtaaagttgatgcattctgtggaggctctatcgttaatgaaaaatggattgtaactgctgcccactgtgt tgaaactggtgttaaaattacagttgtcgcaggtgaacataatattgaggagacagaacatacagagcaaaagcgaaa tgtgattcgaattattcctcaccacaactacaatgcagctattaataagtacaaccatgacattgcccttctggaact ggacgaacccttagtgctaaacagctacgttacacctatttgcattgctgacaaggaatacacgaacatcttcctcaa atttggatctggctatgtaagtggctggggaagagtcttccacaaagggagatcagctttagttcttcagtaccttag agttccacttgttgaccgagccacatgtcttcgatctacaaagttcaccatctataacaacatgttctgtgctggctt ccatgaaggaggtagagattcatgtcaaggagatagtgggggaccccatgttactgaagtggaagggaccagtttctt aactggaattattagctggggtgaagagtgtgcaatgaaaggcaaatatggaatatataccaaggtgtcccggtatgt caactggattaaggaaaaaacaaagctcactgacaaaactcacacatgcccaccgtgcccagctccggaactcctggg cggaccgtcagtcttcctcttccccccaaaacccaaggacaccctcatgatctcccggacccctgaggtcacatgcgt ggtggtggacgtgagccacgaagaccctgaggtcaagttcaactggtacgtggacggcgtggaggtgcataatgccaa gacaaagccgcgggaggaacagtacaacagcacgtaccgtgtggtcagcgtcctcaccgtcctgcaccaggactggct gaatggcaaggagtacaagtgcaaggtctccaacaaagccctcccagcccccatcgagaaaaccatctccaaagccaa agggcagccccgagaaccacaggtgtacaccctgcccccatcccgggatgagctgaccaagaaccaggtcagcctgac ctgcctggtcaaaggcttctatcccagcgacatcgccgtggagtgggagagcaatgggcagccggagaacaactacaa gaccacgcctcccgtgttggactccgacggctccttcttcctctacagcaagctcaccgtggacaagagcaggtggca gcaggggaacgtcttctcatgctccgtgatgcatgaggctctgcacaaccactacacgcagaagagcctctccctgtc tccgggtaaatgagaattcagacatgataagatacattgatgagtttggacaaaccacaactagaatgcagtgaaaaa aatgctttatttgtgaaatttgtgatgctattgctttatttgtaaccattataagctgcaataaacaagttggggtag gcgaagaactccagcatgagatccccgcgctggaggatcatccagccggcgtcccggaaaacgattccgaagcccaac ctttcatagaaggcggcggtggaatcgaaatctcgtagcacgtgtcagtcctgctcctcggccacgaagtgcacgcag ttgccggccgggtcgcgcagggcgaactcccgcccccacggctgctcgccgatctcggtcatggccggcccggaggcg tcccggaagttcgtggacacgacctccgaccactcggcgtacagctcgtccaggccgcgcacccacacccaggccagg gtgttgtccggcaccacctggtcctggaccgcgctgatgaacagggtcacgtcgtcccggaccacaccggcgaagtcg tcctccacgaagtcccgggagaacccgagccggtcggtccagaactcgaccgctccggcgacgtcgcgcgcggtgagc accggaacggcactggtcaacttggccatggtttagttcctcaccttgtcgtattatactatgccgatatactatgcc gatgattaattgtcaacacgtgctgatcagatccgaaaatggatatacaagctcccaggagctttttgcaaaagccta ggcctccaaaaaagcctcctcactacttctggaatagctcagaggcagaggcggcctcggcctctgcataaataaaaa aaattagtcagccatggggcggagaatgggcggaactgggcggagttaggggcgggatgggcggagttaggggcggga ctatggttgctgactaattgagatgcatgctttgcatacttctgcctgctggggagcctggggactttccacacctgg ttgctgactaattgagatgcatgctttgcatacttctgcctgctggggagcctggggactttccacaccctcgtcgag ctagcttcgtgaggctccggtgcccgtcagtgggcagagcgcacatcgcccacagtccccgagaagttggggggaggg gtcggcaattgaaccggtgcctagagaaggtggcgcggggtaaactgggaaagtgatgtcgtgtactggctccgcctt tttcccgagggtgggggagaaccgtatataagtgcagtagtcgccgtgaacgttctttttcgcaacgggtttgccgcc agaacacaggtaagtgccgtgtgtggttcccgcgggcctggcctctttacgggttatggcccttgcgtgccttgaatt acttccacctggctccagtacgtgattcttgatcccgagctggagccaggggcgggccttgcgctttaggagcccctt cgcctcgtgcttgagttgaggcctggcctgggcgctggggccgccgcgtgcgaatctggtggcaccttcgcgcctgtc tcgctgctttcgataagtctctagccatttaaaatttttgatgacctactgcgacgctttttttctggcaagatagtc ttgtaaatgcgggccaggatctgcacactggtatttcggtttttggggccgcgggcggcgacggggcccgtgcgtccc agcgcacatgttcggcgaggcggggcctgcgagcgcggccaccgagaatcggacgggggtagtctcaagctggccggc ctgctctggtgcctggcctcgcgccgccgtgtatcgccccgccctgggcggcaaggctggcccggtcggcaccagttg cgtgagcggaaagatggccgcttcccggccctgctccagggggctcaaaatggaggacgcggcgctcgggagagcggg cgggtgagtcacccacacaaaggaaaggggcctttccgtcctcagccgtcgcttcatgtgactccacggagtaccggg cgccgtccaggcacctcgattagttctggagcttttggagtacgtcgtctttaggttggggggaggggttttatgcga tggagtttccccacactgagtgggtggagactgaagttaggccagcttggcacttgatgtaattctccttggaatttg ccctttttgagtttggatcttggttcattctcaagcctcagacagtggttcaaagtttttttcttccatttcaggtgt cgtgaacacgtggtcgcggccgcgccgccaccatggagacagacacactcctgctatgggtactgctgctctgggttc caggttccactggtgacaaaactcacacatgcccaccgtgcccagcacctgaactcctgggaggaccgtcagtcttcc tcttccccccaaaacccaaggacaccctcatgatctcccggacccctgaggtcacatgcgtggtggtggacgtgagcc acgaagaccctgaggtcaagttcaactggtacgtggacggcgtggaggtgcataatgccaagacaaagccgcgggagg agcagtacaacagcacgtaccgtgtggtcagcgtcctcaccgtcctgcaccaggactggctgaatggcaaggagtaca agtgcaaggtctccaacaaagccctcccagcccccatcgagaaaaccatctccaaagccaaagggcagccccgagaac cacaggtgtacaccctgcccccatcccgcgatgagctgaccaagaaccaggtcagcctgacctgcctggtcaaaggct tctatcccagcgacatcgccgtggagtgggagagcaatgggcagccggagaacaactacaagaccacgcctcccgtgt tggactccgacggctccttcttcctctacagcaagctcaccgtggacaagagcaggtggcagcaggggaacgtcttct catgctccgtgatgcatgaggctctgcacaaccactacacgcagaagagcctctccctgtctccgggtaaatgactcg agagatctggccggctgggcccgtttcgaaggtaagcctatccctaaccctctcctcggtctcgattctacgcgtacc ggtcatcatcaccatcaccattgagtttaaacccgctgatcagcctcgactgtgccttctagttgccagccatctgtt gtttgcccctcccccgtgccttccttgaccctggaaggtgccactcccactgtcctttcctaataaaatgaggaaatt gcatcgcattgtctgagtaggtgtcattctattctggggggtggggtggggcaggacagcaagggggaggattgggaa gacaatagcaggcatgctggggatgcggtgggctctatggcttctgaggcggaaagaaccagtggcggtaatacggtt atccacagaatcaggggataacgcaggaaagaacatgtgagcaaaaggccagcaaaaggccaggaaccgtaaaaaggc cgcgttgctggcgtttttccataggctccgcccccctgacgagcatcacaaaaatcgacgctcaagtcagaggtggcg aaacccgacaggactataaagataccaggcgtttccccctagaagctccctcgtgcgctctcctgttccgaccctgcc gcttaccggatacctgtccgcctttctcccttcgggaagcgtggcgctttctcatagctcacgctgtaggtatctcag ttcggtgtaggtcgttcgctccaagctgggctgtgtgcacgaaccccccgttcagcccgaccgctgcgccttatccgg taactatcgtcttgagtccaacccggtaagacacgacttatcgccactggcagcagccactggtaacaggattagcag agcgaggtatgtaggcggtgctacagagttcttgaagtggtggcctaactacggctacactagaagaacagtatttgg tatctgcgctctgctgaagccagttaccttcggaaaaagagttggtagctcttgatccggcaaacaaaccaccgctgg tagcggtggtttttttgtttgcaagcagcagattacgcgcagaaaaaaaggatctcaagaagatcctttgatcttttc tacggggtctgacgctcagtggaacgaaaactcacgttaagggattttggtcatgacattaacctataaaaataggcg tatcacgaggccctttcgtctcgcgcgtttcggtgatgacggtgaaaacctctgacacatgcagctcccggagacggt cacagcttgtctgtaagcggatgccgggagcagacaagcccgtcaaggcgcgtcagcgggtgttggcgggtgtcgggg ctggcttaactatgcggcatcagagcagattgtactgagagtgcaccatatatgcggtgtgaaataccgcacagatgc gtaaggagaaaataccgcatcaggcgccattcgccattcaggctgcgcaactgttgggaagggcgatcggtgcgggcc tcttcgctattacgcca B. Fc DNA sequence (mouse Igκ signal peptide underlined) (SEQ ID NO: 9, which encodes SEQ ID NO: 10)                                                  ATGGA GACAGACACA CTCCTGCTAT GGGTACTGCT GCTCTGGGTT CCAGGTTCCA CTGGTGACAA AACTCACACA TGCCCACCGT GCCCAGCACC TGAACTCCTG GGAGGACCGT CAGTCTTCCT CTTCCCCCCA AAACCCAAGG ACACCCTCAT GATCTCCCGG ACCCCTGAGG TCACATGCGT GGTGGTGGAC GTGAGCCACG AAGACCCTGA GGTCAAGTTC AACTGGTACG TGGACGGCGT GGAGGTGCAT AATGCCAAGA CAAAGCCGCG GGAGGAGCAG TACAACAGCA CGTACCGTGT GGTCAGCGTC CTCACCGTCC TGCACCAGGA CTGGCTGAAT GGCAAGGAGT ACAAGTGCAA GGTCTCCAAC AAAGCCCTCC CAGCCCCCAT CGAGAAAACC ATCTCCAAAG CCAAAGGGCA GCCCCGAGAA CCACAGGTGT ACACCCTGCC CCCATCCCGC GATGAGCTGA CCAAGAACCA GGTCAGCCTG ACCTGCCTGG TCAAAGGCTT CTATCCCAGC GACATCGCCG TGGAGTGGGA GAGCAATGGG CAGCCGGAGA ACAACTACAA GACCACGCCT CCCGTGTTGG ACTCCGACGG CTCCTTCTTC CTCTACAGCA AGCTCACCGT GGACAAGAGC AGGTGGCAGC AGGGGAACGT CTTCTCATGC TCCGTGATGC ATGAGGCTCT GCACAACCAC TACACGCAGA AGAGCCTCTC CCTGTCTCCG GGTAAA

TABLE 2 Polypeptide Sequences: FIX-Fc A. FIX-Fc chain (SEQ ID NO: 8): (28 amino acid signal sequence underlined, 18 amino acid propeptide double underlined, Fc portion in italics.) The C-terminal lysine is not present in either subunit; this processing is often observed in recombinant proteins produced in mammalian cell culture, as well as with plasma derived proteins. FIXFC-SC SUBUNIT: FIX Signal Peptide: −46 MQRVNMIMAE SPGLITICLL GYLLSAEC FIX Propeptide: −18 TVFLDHENAN KILNRPKR   1 YNSGKLEEFV QGNLERECME EKCSFEEARE VFENTERTTE FWKQYVDGDQ  51 CESNPCLNGG SCKDDINSYE CWCPFGFEGK NCELDVTCNI KNGRCEQFCK 101 NSADNKVVCS CTEGYRLAEN QKSCEPAVPF PCGRVSVSQT SKLTRAETVF 151 PDVDYVNSTE AETILDNITQ STQSFNDFTR VVGGEDAKPG QFPWQVVLNG 201 KVDAFCGGSI VNEKWIVTAA HCVETGVKIT VVAGEHNIEE TEHTEQKRNV 251 IRIIPHHNYN AAINKYNHDI ALLELDEPLV LNSYVTPICI ADKEYTNIFL 301 KFGSGYVSGW GRVFHKGRSA LVLQYLRVPL VDRATCLRST KFTIYNNMFC 351 AGFHEGGRDS CQGDSGGPHV TEVEGTSFLT GIISWGEECA MKGKYGIYTK 401 VSRYVNWIKE KTKLTDKTHT CPPCPAPELL GGPSVFLFPP KPKDTLMISR 451 TPEVTCVVVD VSHEDPEVKF NWYVDGVEVH NAKTKPREEQ YNSTYRVVSV 501 LTVLHQDWLN GKEYKCKVSN KALPAPIEKT ISKAKGQPRE PQVYTLPPSR 551 DELTKNQVSL TCLVKGFYPS DIAVEWESNG QPENNYKTTP PVLDSDGSFF 601 LYSKLTVDKS RWQQGNVFSC SVMHEALHNH YTQKSLSLSP GK MQRVNMIMAESPGLITICLLGYLLSAECTVFLDHENANKILNRP KRYNSGKLEEFVQGNLERECMEEKCSFEEAREVFENTERTTEFWKQYVDGDQCESNPC LNGGSCKDDINSYECWCPFGFEGKNCELDVTCNIKNGRCEQFCKNSADNKVVCSCTEG YRLAENQKSCEPAVPFPCGRVSVSQTSKLTRAETVFPDVDYVNSTEAETILDNITQST QSFNDFTRVVGGEDAKPGQFPWQVVLNGKVDAFCGGSIVNEKWIVTAAHCVETGVKIT VVAGEHNIEETEHTEQKRNVIRIIPHHNYNAAINKYNHDIALLELDEPLVLNSYVTPI CIADKEYTNIFLKFGSGYVSGWGRVFHKGRSALVLQYLRVPLVDRATCLRSTKFTIYN NMFCAGFHEGGRDSCQGDSGGPHVTEVEGTSFLTGIISWGEECAMKGKYGIYTKVSRY VNWIKEKTKLT B. Fc chain (SEQ ID NO: 10) 20 amino acid heterologous mouse Igκ light chain signal peptide (underlined): METDTLLLWV LLLWVPGSTG Mature Fc sequence (corresponding to human IgG1 amino acids 221 to 447, EU numbering)   1 DKTHTCPPCP APELLGGPSV FLFPPKPKDT LMISRTPEVT CVVVDVSHED  51 PEVKFNWYVD GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 101 CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSRDELTK NQVSLTCLVK 151 GFYPSDIAVE WESNGQPENN YKTTPPVLDS DGSFFLYSKL TVDKSRWQQG 201 NVFSCSVMHE ALHNHYTQKS LSLSPGK

TABLE 3 Polynucleotide Sequence: FVIII-Fc A. B-Domain Deleted FVIIIFc (i) B-Domain Deleted FVIIIFc Chain DNA Sequence (FVIII signal peptide underlined, Fc region in bold) (SEQ ID NO: 11, which encodes SEQ ID NO: 12)  661                                                     A TGCAAATAGA GCTCTCCACC TGCTTCTTTC  721 TGTGCCTTTT GCGATTCTGC TTTAGTGCCA CCAGAAGATA CTACCTGGGT GCAGTGGAAC  781 TGTCATGGGA CTATATGCAA AGTGATCTCG GTGAGCTGCC TGTGGACGCA AGATTTCCTC  841 CTAGAGTGCC AAAATCTTTT CCATTCAACA CCTCAGTCGT GTACAAAAAG ACTCTGTTTG  901 TAGAATTCAC GGATCACCTT TTCAACATCG CTAAGCCAAG GCCACCCTGG ATGGGTCTGC  961 TAGGTCCTAC CATCCAGGCT GAGGTTTATG ATACAGTGGT CATTACACTT AAGAACATGG 1021 CTTCCCATCC TGTCAGTCTT CATGCTGTTG GTGTATCCTA CTGGAAAGCT TCTGAGGGAG 1081 CTGAATATGA TGATCAGACC AGTCAAAGGG AGAAAGAAGA TGATAAAGTC TTCCCTGGTG 1141 GAAGCCATAC ATATGTCTGG CAGGTCCTGA AAGAGAATGG TCCAATGGCC TCTGACCCAC 1201 TGTGCCTTAC CTACTCATAT CTTTCTCATG TGGACCTGGT AAAAGACTTG AATTCAGGCC 1261 TCATTGGAGC CCTACTAGTA TGTAGAGAAG GGAGTCTGGC CAAGGAAAAG ACACAGACCT 1321 TGCACAAATT TATACTACTT TTTGCTGTAT TTGATGAAGG GAAAAGTTGG CACTCAGAAA 1381 CAAAGAACTC CTTGATGCAG GATAGGGATG CTGCATCTGC TCGGGCCTGG CCTAAAATGC 1441 ACACAGTCAA TGGTTATGTA AACAGGTCTC TGCCAGGTCT GATTGGATGC CACAGGAAAT 1501 CAGTCTATTG GCATGTGATT GGAATGGGCA CCACTCCTGA AGTGCACTCA ATATTCCTCG 1561 AAGGTCACAC ATTTCTTGTG AGGAACCATC GCCAGGCGTC CTTGGAAATC TCGCCAATAA 1621 CTTTCCTTAC TGCTCAAACA CTCTTGATGG ACCTTGGACA GTTTCTACTG TTTTGTCATA 1681 TCTCTTCCCA CCAACATGAT GGCATGGAAG CTTATGTCAA AGTAGACAGC TGTCCAGAGG 1741 AACCCCAACT ACGAATGAAA AATAATGAAG AAGCGGAAGA CTATGATGAT GATCTTACTG 1801 ATTCTGAAAT GGATGTGGTC AGGTTTGATG ATGACAACTC TCCTTCCTTT ATCCAAATTC 1861 GCTCAGTTGC CAAGAAGCAT CCTAAAACTT GGGTACATTA CATTGCTGCT GAAGAGGAGG 1921 ACTGGGACTA TGCTCCCTTA GTCCTCGCCC CCGATGACAG AAGTTATAAA AGTCAATATT 1981 TGAACAATGG CCCTCAGCGG ATTGGTAGGA AGTACAAAAA AGTCCGATTT ATGGCATACA 2041 CAGATGAAAC CTTTAAGACT CGTGAAGCTA TTCAGCATGA ATCAGGAATC TTGGGACCTT 2101 TACTTTATGG GGAAGTTGGA GACACACTGT TGATTATATT TAAGAATCAA GCAAGCAGAC 2161 CATATAACAT CTACCCTCAC GGAATCACTG ATGTCCGTCC TTTGTATTCA AGGAGATTAC 2221 CAAAAGGTGT AAAACATTTG AAGGATTTTC CAATTCTGCC AGGAGAAATA TTCAAATATA 2281 AATGGACAGT GACTGTAGAA GATGGGCCAA CTAAATCAGA TCCTCGGTGC CTGACCCGCT 2341 ATTACTCTAG TTTCGTTAAT ATGGAGAGAG ATCTAGCTTC AGGACTCATT GGCCCTCTCC 2401 TCATCTGCTA CAAAGAATCT GTAGATCAAA GAGGAAACCA GATAATGTCA GACAAGAGGA 2461 ATGTCATCCT GTTTTCTGTA TTTGATGAGA ACCGAAGCTG GTACCTCACA GAGAATATAC 2521 AACGCTTTCT CCCCAATCCA GCTGGAGTGC AGCTTGAGGA TCCAGAGTTC CAAGCCTCCA 2581 ACATCATGCA CAGCATCAAT GGCTATGTTT TTGATAGTTT GCAGTTGTCA GTTTGTTTGC 2641 ATGAGGTGGC ATACTGGTAC ATTCTAAGCA TTGGAGCACA GACTGACTTC CTTTCTGTCT 2701 TCTTCTCTGG ATATACCTTC AAACACAAAA TGGTCTATGA AGACACACTC ACCCTATTCC 2761 CATTCTCAGG AGAAACTGTC TTCATGTCGA TGGAAAACCC AGGTCTATGG ATTCTGGGGT 2821 GCCACAACTC AGACTTTCGG AACAGAGGCA TGACCGCCTT ACTGAAGGTT TCTAGTTGTG 2881 ACAAGAACAC TGGTGATTAT TACGAGGACA GTTATGAAGA TATTGCTGCA TACTTGCTGA 2941 GTAAAAACAA TGCCATTGAA CCAAGAAGCT TCTCTCAAAA CCCACCAGTC TTGAAACGCC 3001 ATCAACGGGA AATAACTCGT ACTACTCTTC AGTCAGATCA AGAGGAAATT GACTATGATG 3061 ATACCATATC AGTTGAAATG AAGAAGGAAG ATTTTGACAT TTATGATGAG GATGAAAATC 3121 AGAGCCCCCG CAGCTTTCAA AAGAAAACAC GACACTATTT TATTGCTGCA GTGGAGAGGC 3181 TCTGGGATTA TGGGATGAGT AGCTCCCCAC ATGTTCTAAG AAACAGGGCT CAGAGTGGCA 3241 GTGTCCCTCA GTTCAAGAAA GTTGTTTTCC AGGAATTTAC TGATGGCTCC TTTACTCAGC 3301 CCTTATACCG TGGAGAACTA AATGAACATT TGGGACTCCT GGGGCCATAT ATAAGAGCAG 3361 AAGTTGAAGA TAATATCATG GTAACTTTCA GAAATCAGGC CTCTCGTCCC TATTCCTTCT 3421 ATTCTAGCCT TATTTCTTAT GAGGAAGATC AGAGGCAAGG AGCAGAACCT AGAAAAAACT 3481 TTGTCAAGCC TAATGAAACC AAAACTTACT TTTGGAAAGT GCAACATCAT ATGGCACCCA 3541 CTAAAGATGA GTTTGACTGC AAAGCCTGGG CTTATTTCTC TGATGTTGAC CTGGAAAAAG 3601 ATGTGCACTC AGGCCTGATT GGACCCCTTC TGGTCTGCCA CACTAACACA CTGAACCCTG 3661 CTCATGGGAG ACAAGTGACA GTACAGGAAT TTGCTCTGTT TTTCACCATC TTTGATGAGA 3721 CCAAAAGCTG GTACTTCACT GAAAATATGG AAAGAAACTG CAGGGCTCCC TGCAATATCC 3781 AGATGGAAGA TCCCACTTTT AAAGAGAATT ATCGCTTCCA TGCAATCAAT GGCTACATAA 3841 TGGATACACT ACCTGGCTTA GTAATGGCTC AGGATCAAAG GATTCGATGG TATCTGCTCA 3901 GCATGGGCAG CAATGAAAAC ATCCATTCTA TTCATTTCAG TGGACATGTG TTCACTGTAC 3961 GAAAAAAAGA GGAGTATAAA ATGGCACTGT ACAATCTCTA TCCAGGTGTT TTTGAGACAG 4021 TGGAAATGTT ACCATCCAAA GCTGGAATTT GGCGGGTGGA ATGCCTTATT GGCGAGCATC 4081 TACATGCTGG GATGAGCACA CTTTTTCTGG TGTACAGCAA TAAGTGTCAG ACTCCCCTGG 4141 GAATGGCTTC TGGACACATT AGAGATTTTC AGATTACAGC TTCAGGACAA TATGGACAGT 4201 GGGCCCCAAA GCTGGCCAGA CTTCATTATT CCGGATCAAT CAATGCCTGG AGCACCAAGG 4261 AGCCCTTTTC TTGGATCAAG GTGGATCTGT TGGCACCAAT GATTATTCAC GGCATCAAGA 4321 CCCAGGGTGC CCGTCAGAAG TTCTCCAGCC TCTACATCTC TCAGTTTATC ATCATGTATA 4381 GTCTTGATGG GAAGAAGTGG CAGACTTATC GAGGAAATTC CACTGGAACC TTAATGGTCT 4441 TCTTTGGCAA TGTGGATTCA TCTGGGATAA AACACAATAT TTTTAACCCT CCAATTATTG 4501 CTCGATACAT CCGTTTGCAC CCAACTCATT ATAGCATTCG CAGCACTCTT CGCATGGAGT 4561 TGATGGGCTG TGATTTAAAT AGTTGCAGCA TGCCATTGGG AATGGAGAGT AAAGCAATAT 4621 CAGATGCACA GATTACTGCT TCATCCTACT TTACCAATAT GTTTGCCACC TGGTCTCCTT 4681 CAAAAGCTCG ACTTCACCTC CAAGGGAGGA GTAATGCCTG GAGACCTCAG GTGAATAATC 4741 CAAAAGAGTG GCTGCAAGTG GACTTCCAGA AGACAATGAA AGTCACAGGA GTAACTACTC 4801 AGGGAGTAAA ATCTCTGCTT ACCAGCATGT ATGTGAAGGA GTTCCTCATC TCCAGCAGTC 4861 AAGATGGCCA TCAGTGGACT CTCTTTTTTC AGAGTGCCAA AGTAAAGGTT TTTCAGGGAA 4921 ATCAAGACTC CTTCACACCT GTGGTGAACT CTCTAGACCC ACCGTTACTG ACTCGCTACC 4981 TTCGAATTCA CCCCCAGAGT TGGGTGCACC AGATTGCCCT GAGGATGGAG GTTCTGGGCT 5041 GCGAGGCACA GGACCTCTAC GACAAAACTC ACACATGCCC ACCGTGCCCA GCTCCAGAAC 5101 TCCTGGGCGG ACCGTCAGTC TTCCTCTTCC CCCCAAAACC CAAGGACACC CTCATGATCT 5161 CCCGGACCCC TGAGGTCACA TGCGTGGTGG TGGACGTGAG CCACGAAGAC CCTGAGGTCA 5221 AGTTCAACTG GTACGTGGAC GGCGTGGAGG TGCATAATGC CAAGACAAAG CCGCGGGAGG 5281 AGCAGTACAA CAGCACGTAC CGTGTGGTCA GCGTCCTCAC CGTCCTGCAC CAGGACTGGC 5341 TGAATGGCAA GGAGTACAAG TGCAAGGTCT CCAACAAAGC CCTCCCAGCC CCCATCGAGA 5401 AAACCATCTC CAAAGCCAAA GGGCAGCCCC GAGAACCACA GGTGTACACC CTGCCCCCAT 5461 CCCGGGATGA GCTGACCAAG AACCAGGTCA GCCTGACCTG CCTGGTCAAA GGCTTCTATC 5521 CCAGCGACAT CGCCGTGGAG TGGGAGAGCA ATGGGCAGCC GGAGAACAAC TACAAGACCA 5581 CGCCTCCCGT GTTGGACTCC GACGGCTCCT TCTTCCTCTA CAGCAAGCTC ACCGTGGACA 5641 AGAGCAGGTG GCAGCAGGGG AACGTCTTCT CATGCTCCGT GATGCATGAG GCTCTGCACA 5701 ACCACTACAC GCAGAAGAGC CTCTCCCTGT CTCCGGGTAA A B. Full-length FVIIIFc (i): Full-length FVIIIFc DNA Sequence (FVIII signal   peptide underlined. Fc region in bold)  (SEQ ID NO: 13, which encodes SEQ ID NO: 14)  661                                          ATG CAAATAGAGC TCTCCACCTG  721 CTTCTTTCTG TGCCTTTTGC GATTCTGCTT TAGTGCCACC AGAAGATACT ACCTGGGTGC  781 AGTGGAACTG TCATGGGACT ATATGCAAAG TGATCTCGGT GAGCTGCCTG TGGACGCAAG  841 ATTTCCTCCT AGAGTGCCAA AATCTTTTCC ATTCAACACC TCAGTCGTGT ACAAAAAGAC  901 TCTGTTTGTA GAATTCACGG ATCACCTTTT CAACATCGCT AAGCCAAGGC CACCCTGGAT  961 GGGTCTGCTA GGTCCTACCA TCCAGGCTGA GGTTTATGAT ACAGTGGTCA TTACACTTAA 1021 GAACATGGCT TCCCATCCTG TCAGTCTTCA TGCTGTTGGT GTATCCTACT GGAAAGCTTC 1081 TGAGGGAGCT GAATATGATG ATCAGACCAG TCAAAGGGAG AAAGAAGATG ATAAAGTCTT 1141 CCCTGGTGGA AGCCATACAT ATGTCTGGCA GGTCCTGAAA GAGAATGGTC CAATGGCCTC 1201 TGACCCACTG TGCCTTACCT ACTCATATCT TTCTCATGTG GACCTGGTAA AAGACTTGAA 1261 TTCAGGCCTC ATTGGAGCCC TACTAGTATG TAGAGAAGGG AGTCTGGCCA AGGAAAAGAC 1321 ACAGACCTTG CACAAATTTA TACTACTTTT TGCTGTATTT GATGAAGGGA AAAGTTGGCA 1381 CTCAGAAACA AAGAACTCCT TGATGCAGGA TAGGGATGCT GCATCTGCTC GGGCCTGGCC 1441 TAAAATGCAC ACAGTCAATG GTTATGTAAA CAGGTCTCTG CCAGGTCTGA TTGGATGCCA 1501 CAGGAAATCA GTCTATTGGC ATGTGATTGG AATGGGCACC ACTCCTGAAG TGCACTCAAT 1561 ATTCCTCGAA GGTCACACAT TTCTTGTGAG GAACCATCGC CAGGCGTCCT TGGAAATCTC 1621 GCCAATAACT TTCCTTACTG CTCAAACACT CTTGATGGAC CTTGGACAGT TTCTACTGTT 1681 TTGTCATATC TCTTCCCACC AACATGATGG CATGGAAGCT TATGTCAAAG TAGACAGCTG 1741 TCCAGAGGAA CCCCAACTAC GAATGAAAAA TAATGAAGAA GCGGAAGACT ATGATGATGA 1801 TCTTACTGAT TCTGAAATGG ATGTGGTCAG GTTTGATGAT GACAACTCTC CTTCCTTTAT 1861 CCAAATTCGC TCAGTTGCCA AGAAGCATCC TAAAACTTGG GTACATTACA TTGCTGCTGA 1921 AGAGGAGGAC TGGGACTATG CTCCCTTAGT CCTCGCCCCC GATGACAGAA GTTATAAAAG 1981 TCAATATTTG AACAATGGCC CTCAGCGGAT TGGTAGGAAG TACAAAAAAG TCCGATTTAT 2041 GGCATACACA GATGAAACCT TTAAGACTCG TGAAGCTATT CAGCATGAAT CAGGAATCTT 2101 GGGACCTTTA CTTTATGGGG AAGTTGGAGA CACACTGTTG ATTATATTTA AGAATCAAGC 2161 AAGCAGACCA TATAACATCT ACCCTCACGG AATCACTGAT GTCCGTCCTT TGTATTCAAG 2221 GAGATTACCA AAAGGTGTAA AACATTTGAA GGATTTTCCA ATTCTGCCAG GAGAAATATT 2281 CAAATATAAA TGGACAGTGA CTGTAGAAGA TGGGCCAACT AAATCAGATC CTCGGTGCCT 2341 GACCCGCTAT TACTCTAGTT TCGTTAATAT GGAGAGAGAT CTAGCTTCAG GACTCATTGG 2401 CCCTCTCCTC ATCTGCTACA AAGAATCTGT AGATCAAAGA GGAAACCAGA TAATGTCAGA 2461 CAAGAGGAAT GTCATCCTGT TTTCTGTATT TGATGAGAAC CGAAGCTGGT ACCTCACAGA 2521 GAATATACAA CGCTTTCTCC CCAATCCAGC TGGAGTGCAG CTTGAGGATC CAGAGTTCCA 2581 AGCCTCCAAC ATCATGCACA GCATCAATGG CTATGTTTTT GATAGTTTGC AGTTGTCAGT 2641 TTGTTTGCAT GAGGTGGCAT ACTGGTACAT TCTAAGCATT GGAGCACAGA CTGACTTCCT 2701 TTCTGTCTTC TTCTCTGGAT ATACCTTCAA ACACAAAATG GTCTATGAAG ACACACTCAC 2761 CCTATTCCCA TTCTCAGGAG AAACTGTCTT CATGTCGATG GAAAACCCAG GTCTATGGAT 2821 TCTGGGGTGC CACAACTCAG ACTTTCGGAA CAGAGGCATG ACCGCCTTAC TGAAGGTTTC 2881 TAGTTGTGAC AAGAACACTG GTGATTATTA CGAGGACAGT TATGAAGATA TTTCAGCATA 2941 CTTGCTGAGT AAAAACAATG CCATTGAACC AAGAAGCTTC TCCCAGAATT CAAGACACCC 3001 TAGCACTAGG CAAAAGCAAT TTAATGCCAC CACAATTCCA GAAAATGACA TAGAGAAGAC 3061 TGACCCTTGG TTTGCACACA GAACACCTAT GCCTAAAATA CAAAATGTCT CCTCTAGTGA 3121 TTTGTTGATG CTCTTGCGAC AGAGTCCTAC TCCACATGGG CTATCCTTAT CTGATCTCCA 3181 AGAAGCCAAA TATGAGACTT TTTCTGATGA TCCATCACCT GGAGCAATAG ACAGTAATAA 3241 CAGCCTGTCT GAAATGACAC ACTTCAGGCC ACAGCTCCAT CACAGTGGGG ACATGGTATT 3301 TACCCCTGAG TCAGGCCTCC AATTAAGATT AAATGAGAAA CTGGGGACAA CTGCAGCAAC 3361 AGAGTTGAAG AAACTTGATT TCAAAGTTTC TAGTACATCA AATAATCTGA TTTCAACAAT 3421 TCCATCAGAC AATTTGGCAG CAGGTACTGA TAATACAAGT TCCTTAGGAC CCCCAAGTAT 3481 GCCAGTTCAT TATGATAGTC AATTAGATAC CACTCTATTT GGCAAAAAGT CATCTCCCCT 3541 TACTGAGTCT GGTGGACCTC TGAGCTTGAG TGAAGAAAAT AATGATTCAA AGTTGTTAGA 3601 ATCAGGTTTA ATGAATAGCC AAGAAAGTTC ATGGGGAAAA AATGTATCGT CAACAGAGAG 3661 TGGTAGGTTA TTTAAAGGGA AAAGAGCTCA TGGACCTGCT TTGTTGACTA AAGATAATGC 3721 CTTATTCAAA GTTAGCATCT CTTTGTTAAA GACAAACAAA ACTTCCAATA ATTCAGCAAC 3781 TAATAGAAAG ACTCACATTG ATGGCCCATC ATTATTAATT GAGAATAGTC CATCAGTCTG 3841 GCAAAATATA TTAGAAAGTG ACACTGAGTT TAAAAAAGTG ACACCTTTGA TTCATGACAG 3901 AATGCTTATG GACAAAAATG CTACAGCTTT GAGGCTAAAT CATATGTCAA ATAAAACTAC 3961 TTCATCAAAA AACATGGAAA TGGTCCAACA GAAAAAAGAG GGCCCCATTC CACCAGATGC 4021 ACAAAATCCA GATATGTCGT TCTTTAAGAT GCTATTCTTG CCAGAATCAG CAAGGTGGAT 4081 ACAAAGGACT CATGGAAAGA ACTCTCTGAA CTCTGGGCAA GGCCCCAGTC CAAAGCAATT 4141 AGTATCCTTA GGACCAGAAA AATCTGTGGA AGGTCAGAAT TTCTTGTCTG AGAAAAACAA 4201 AGTGGTAGTA GGAAAGGGTG AATTTACAAA GGACGTAGGA CTCAAAGAGA TGGTTTTTCC 4261 AAGCAGCAGA AACCTATTTC TTACTAACTT GGATAATTTA CATGAAAATA ATACACACAA 4321 TCAAGAAAAA AAAATTCAGG AAGAAATAGA AAAGAAGGAA ACATTAATCC AAGAGAATGT 4381 AGTTTTGCCT CAGATACATA CAGTGACTGG CACTAAGAAT TTCATGAAGA ACCTTTTCTT 4441 ACTGAGCACT AGGCAAAATG TAGAAGGTTC ATATGACGGG GCATATGCTC CAGTACTTCA 4501 AGATTTTAGG TCATTAAATG ATTCAACAAA TAGAACAAAG AAACACACAG CTCATTTCTC 4561 AAAAAAAGGG GAGGAAGAAA ACTTGGAAGG CTTGGGAAAT CAAACCAAGC AAATTGTAGA 4621 GAAATATGCA TGCACCACAA GGATATCTCC TAATACAAGC CAGCAGAATT TTGTCACGCA 4681 ACGTAGTAAG AGAGCTTTGA AACAATTCAG ACTCCCACTA GAAGAAACAG AACTTGAAAA 4741 AAGGATAATT GTGGATGACA CCTCAACCCA GTGGTCCAAA AACATGAAAC ATTTGACCCC 4801 GAGCACCCTC ACACAGATAG ACTACAATGA GAAGGAGAAA GGGGCCATTA CTCAGTCTCC 4861 CTTATCAGAT TGCCTTACGA GGAGTCATAG CATCCCTCAA GCAAATAGAT CTCCATTACC 4921 CATTGCAAAG GTATCATCAT TTCCATCTAT TAGACCTATA TATCTGACCA GGGTCCTATT 4981 CCAAGACAAC TCTTCTCATC TTCCAGCAGC ATCTTATAGA AAGAAAGATT CTGGGGTCCA 5041 AGAAAGCAGT CATTTCTTAC AAGGAGCCAA AAAAAATAAC CTTTCTTTAG CCATTCTAAC 5101 CTTGGAGATG ACTGGTGATC AAAGAGAGGT TGGCTCCCTG GGGACAAGTG CCACAAATTC 5161 AGTCACATAC AAGAAAGTTG AGAACACTGT TCTCCCGAAA CCAGACTTGC CCAAAACATC 5221 TGGCAAAGTT GAATTGCTTC CAAAAGTTCA CATTTATCAG AAGGACCTAT TCCCTACGGA 5281 AACTAGCAAT GGGTCTCCTG GCCATCTGGA TCTCGTGGAA GGGAGCCTTC TTCAGGGAAC 5341 AGAGGGAGCG ATTAAGTGGA ATGAAGCAAA CAGACCTGGA AAAGTTCCCT TTCTGAGAGT 5401 AGCAACAGAA AGCTCTGCAA AGACTCCCTC CAAGCTATTG GATCCTCTTG CTTGGGATAA 5461 CCACTATGGT ACTCAGATAC CAAAAGAAGA GTGGAAATCC CAAGAGAAGT CACCAGAAAA 5521 AACAGCTTTT AAGAAAAAGG ATACCATTTT GTCCCTGAAC GCTTGTGAAA GCAATCATGC 5581 AATAGCAGCA ATAAATGAGG GACAAAATAA GCCCGAAATA GAAGTCACCT GGGCAAAGCA 5641 AGGTAGGACT GAAAGGCTGT GCTCTCAAAA CCCACCAGTC TTGAAACGCC ATCAACGGGA 5701 AATAACTCGT ACTACTCTTC AGTCAGATCA AGAGGAAATT GACTATGATG ATACCATATC 5761 AGTTGAAATG AAGAAGGAAG ATTTTGACAT TTATGATGAG GATGAAAATC AGAGCCCCCG 5821 CAGCTTTCAA AAGAAAACAC GACACTATTT TATTGCTGCA GTGGAGAGGC TCTGGGATTA 5881 TGGGATGAGT AGCTCCCCAC ATGTTCTAAG AAACAGGGCT CAGAGTGGCA GTGTCCCTCA 5941 GTTCAAGAAA GTTGTTTTCC AGGAATTTAC TGATGGCTCC TTTACTCAGC CCTTATACCG 6001 TGGAGAACTA AATGAACATT TGGGACTCCT GGGGCCATAT ATAAGAGCAG AAGTTGAAGA 6061 TAATATCATG GTAACTTTCA GAAATCAGGC CTCTCGTCCC TATTCCTTCT ATTCTAGCCT 6121 TATTTCTTAT GAGGAAGATC AGAGGCAAGG AGCAGAACCT AGAAAAAACT TTGTCAAGCC 6181 TAATGAAACC AAAACTTACT TTTGGAAAGT GCAACATCAT ATGGCACCCA CTAAAGATGA 6241 GTTTGACTGC AAAGCCTGGG CTTATTTCTC TGATGTTGAC CTGGAAAAAG ATGTGCACTC 8301 AGGCCTGATT GGACCCCTTC TGGTCTGCCA CACTAACACA CTGAACCCTG CTCATGGGAG 6361 ACAAGTGACA GTACAGGAAT TTGCTCTGTT TTTCACCATC TTTGATGAGA CCAAAAGCTG 6421 GTACTTCACT GAAAATATGG AAAGAAACTG CAGGGCTCCC TGCAATATCC AGATGGAAGA 8481 TCCCACTTTT AAAGAGAATT ATCGCTTCCA TGCAATCAAT GGCTACATAA TGGATACACT 6541 ACCTGGCTTA GTAATGGCTC AGGATCAAAG GATTCGATGG TATCTGCTCA GCATGGGCAG 6601 CAATGAAAAC ATCCATTCTA TTCATTTCAG TGGACATGTG TTCACTGTAC GAAAAAAAGA 6861 GGAGTATAAA ATGGCACTGT ACAATCTCTA TCCAGGTGTT TTTGAGACAG TGGAAATGTT 6721 ACCATCCAAA GCTGGAATTT GGCGGGTGGA ATGCCTTATT GGCGAGCATC TACATGCTGG 6781 GATGAGCACA CTTTTTCTGG TGTACAGCAA TAAGTGTCAG ACTCCCCTGG GAATGGCTTC 6841 TGGACACATT AGAGATTTTC AGATTACAGC TTCAGGACAA TATGGACAGT GGGCCCCAAA 6901 GCTGGCCAGA CTTCATTATT CCGGATCAAT CAATGCCTGG AGCACCAAGG AGCCCTTTTC 6961 TTGGATCAAG GTGGATCTGT TGGCACCAAT GATTATTCAC GGCATCAAGA CCCAGGGTGC 7021 CCGTCAGAAG TTCTCCAGCC TCTACATCTC TCAGTTTATC ATCATGTATA GTCTTGATGG 7081 GAAGAAGTGG CAGACTTATC GAGGAAATTC CACTGGAACC TTAATGGTCT TCTTTGGCAA 7141 TGTGGATTCA TCTGGGATAA AACACAATAT TTTTAACCCT CCAATTATTG CTCGATACAT 7201 CCGTTTGCAC CCAACTCATT ATAGCATTCG CAGCACTCTT CGCATGGAGT TGATGGGCTG 7261 TGATTTAAAT AGTTGCAGCA TGCCATTGGG AATGGAGAGT AAAGCAATAT CAGATGCACA 7321 GATTACTGCT TCATCCTACT TTACCAATAT GTTTGCCACC TGGTCTCCTT CAAAAGCTCG 7381 ACTTCACCTC CAAGGGAGGA GTAATGCCTG GAGACCTCAG GTGAATAATC CAAAAGAGTG 7441 GCTGCAAGTG GACTTCCAGA AGACAATGAA AGTCACAGGA GTAACTACTC AGGGAGTAAA 7501 ATCTCTGCTT ACCAGCATGT ATGTGAAGGA GTTCCTCATC TCCAGCAGTC AAGATGGCCA 7561 TCAGTGGACT CTCTTTTTTC AGAATGGCAA AGTAAAGGTT TTTCAGGGAA ATCAAGACTC 7621 CTTCACACCT GTGGTGAACT CTCTAGACCC ACCGTTACTG ACTCGCTACC TTCGAATTCA 7681 CCCCCAGAGT TGGGTGCACC AGATTGCCCT GAGGATGGAG GTTCTGGGCT GCGAGGCACA 7741 GGACCTCTAC GACAAAACTC ACACATGCCC ACCGTGCCCA GCTCCAGAAC TCCTGGGCGG 7801 ACCGTCAGTC TTCCTCTTCC CCCCAAAACC CAAGGACACC CTCATGATCT CCCGGACCCC 7861 TGAGGTCACA TGCGTGGTGG TGGACGTGAG CCACGAAGAC CCTGAGGTCA AGTTCAACTG 7921 GTACGTGGAC GGCGTGGAGG TGCATAATGC CAAGACAAAG CCGCGGGAGG AGCAGTACAA 7981 CAGCACGTAC CGTGTGGTCA GCGTCCTCAC CGTCCTGCAC CAGGACTGGC TGAATGGCAA 8041 GGAGTACAAG TGCAAGGTCT CCAACAAAGC CCTCCCAGCC CCCATCGAGA AAACCATCTC 8101 CAAAGCCAAA GGGCAGCCCC GAGAACCACA GGTGTACACC CTGCCCCCAT CCCGGGATGA 8161 GCTGACCAAG AACCAGGTCA GCCTGACCTG CCTGGTCAAA GGCTTCTATC CCAGCGACAT 8221 CGCCGTGGAG TGGGAGAGCA ATGGGCAGCC GGAGAACAAC TACAAGACCA CGCCTCCCGT 8281 GTTGGACTCC GACGGCTCCT TCTTCCTCTA CAGCAAGCTC ACCGTGGACA AGAGCAGGTG 8341 GCAGCAGGGG AACGTCTTCT CATGCTCCGT GATGCATGAG GCTCTGCACA ACCACTACAC 8401 GCAGAAGAGC CTCTCCCTGT CTCCGGGTAA A

TABLE 4 Polypeptide Sequence: FVIII-Fc A. B-Domain Deleted FVIII-Fc (BDD FVIIIFc): Construct = HC-LC-Fc fusion. An Fc expression cassette is cotransfected with BDDFVIII-Fc to generate the BDD FVIIIFc monomer. For the BDD FVIIIFc chain, the Fc sequence is shown in bold; HC sequence is shown in double underline; remaining B domain sequence is shown in italics. Signal peptides are underlined. i) B domain deleted FVIII-Fc chain (19 amino acid signal sequence underlined) (SEQ ID NO: 12) FVIII SIGNAL PEPTIDE: MQIELSTCFFLCLLRFCFS FVIII MATURE POLYPEPTIDE SEQUENCE: ATRRYYLGAVELSWDYMQSDLGELPVDARFPPRVPKSFPFNTSVVYKKILFVEFTDHLFNIAKPRPPWMGLLGPTIQAEVYDTVVITLKNMASHPVS LHAVGVSYWKASEGAEYDDQTSQREKEDDKVFPGGSHTYVWQVLKENGPMASDPLCLTYSYLSHVDLVKDLNSGLIGALLVCREGSLAKEKTQTLH KFILLFAVFDEGKSWHSETKNSLMQDRDAASARAWPKMHTVNGYVNRSLPGLIGCHRKSVYWHVIGMGTTPEVHSIFLEGHTFLVRNHRQASLEIS PITFLTAQTLLMDLGQPLLFCHISSHQHDGMEAYVKVDSCPEEPQLRMKNNEEAEDYDDDLTDSEMDVVREDDDNSPSFIQIRSVAKKHPKTWVH YIAAEEEDWDYAPLVLAPDDRSYKSQYLNNGPQRIGRKYKKVRFMAYTDETFKTREAIQHESGILGPLLYGEVGDTLLIIFKNQASRPYNIYPHGITDVR PLYSRRLPKGVKHLKDFPILPGEIFKYKWTVTVEDGPTKSDPRCLTRYYSSFVNMERDLASGLIGPLLICYKESVDQRGNQIMSDKRNVILFSVFDENRS WYLTENIQRFLPNPAGVQLEDPEFQASNIMHSINGYVFDSLQLSVCLHEVAYWYILSIGAQTDFLSVFFSGYTFKHKMVYEDTLTLFPFSGETVFMSM ENPGLWILGCHNSDFRNRGMTALLKVSSCDKNTGDVYEDSYEDISAYLLSKNNAIEPR SFSQNPPVLKRHQREITRTTLQSDQEEIDYDDTISVEMKK EDFDIYDEDENQSPRSFQKKTRHYFIAAVERLWDYGMSSSPHVLRNRAQSGSVPQFKKVVFQEFTDGSFTQPLYRGELNEHLGLLGPYIRAEVEDNI MVTFRNQASRPYSFYSSLISYEEDQRQGAEPRKNFVKPNETKTYFWKVQHHMAPTKDEFDCKAWAYFSDVDLEKDVHSGLIGPLLVCHTNTLNPA HGRQVTVQEFALFFTIFDETKSWYFTENMERNCRAPCNIQMEDPTFKENYRFHAINGYIMDTLPGLVMAQDQRIRWYLLSMGSNENIHSIHFSGH VFTVRKKEEYKMALYNLYPGVFETVEMLPSKAGIWRVECLIGEHLHAGMSTLFLVYSNKCQTPLGMASGHIRDFQITASGQYGQWAPKLARLHYSG SINAWSTKEPFSWIKVDLLAPMIIHGIKTQGARQKFSSLYISQFIIMYSLDGKKWQTYRGNSTGTLMVFFGNVDSSGIKHNIFNPPIIARYIRLHPTHYSI RSTLRMELMGCDLNSCSMPLGMESKAISDAQITASSYFTNMFATWSPSKARLHLQGRSNAWRPQVNNPKEWLQVDFQKTMKVTGVTTQGVKSL LTSMYVKEFLISSSQDGHQWTLFFQNGKVKVFQGNQDSFTPVVNSLDPPLLTRYLRIHPQSWVHQIALRMEVLGCEAQDLYDKTHTCPPCPAPELL GGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKAL PAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVF SCSVMHEALHNHYTQKSLSLSPGK B. Full-length FVIIIFc. Construct = HC-B-LC-Fc fusion. An Fc expression cassette is cotransfected with full-length FVIII-Fc to generate the full-length FVIIIFc monomer. For the FVIIIFc chain, the Fc sequence is shown in bold; HC sequence is shown in double underline; B domain sequence is shown in italics. Signal peptides are underlined. i) Full-length FVIIIFc chain (FVIII signal peptide underlined (SEQ ID NO: 14) FVIII SIGNAL PEPTIDE: MQIELSTCFFLCLLRFCFS FVIII MATURE SEQUENCE: ATRRYYLGAVELSWDYMQSDLGELPVDARFPPRVPKSFPFNTSVVYKKTLFVEFTDHLFNIAKPRPPWMGLLGPTIQAEVYDTVVI TLKNMASHPVSLHAVGVSYWKASEGAEYDDQTSQREKEDDKVFPGGSHTYVWQVLKENGPMASDPLCLTYSYLSHVDLVKDLNSGL IGALLVCREGSLAKEKTQTLHKFILLFAVFDEGKSWHSETKNSLMQDRDAASARAWPKMHTVNGYVNRSLPGLIGCHRKSVYWHVI GMGTTPEVHSIFLEGHTFLVRNHRQASLEISPITFLTAQTLLMDLGQFLLFCHISSHQHDGMEAYVKVDSCPEEPQLRMKNNEEAE DYDDDLTDSEMDVVRFDDDNSPSFIQIRSVAKKHPKTWVHYIAAEEEDWDYAPLVLAPDDRSYKSQYLNNGPQRIQRKYKKVRFMA YTDETFKTREAIQHESGILGPLLYGEVGDTLLIIFKNQASRPYNIYPHGITDVRPLYSRRLPKGVKHLKDFPILPGEIFKYKWTVT VEDGPTKSDPRCLTRYYSSFVNMERDLASGLIGPLLICYKESVDQRGNQIMSDKRNVILFSVFDENRSWYLTENIQRFLPNPAGVQ LEDPEFQASNIMHSINGYVFDSLQLSVCLHEVAYWYILSIGAQTDFLSVFPSGYTFKHKMVYEDTLTLFPFSGETVFMSMENPGLW ILGCHNSDFRNRGMTALLKVSSCDKNTGDYYEDSYERISAYLLSKNNAIEPR SFSQNSRHPSTRQKQFNATTIPENDIEKTDPWFA HRTPMPKIQNVSSSDLLMLLROSPTPHGLSLSDLQEAKYETFSDDPSPGAIDSNNSLSEMTHFRPQLHHSGDMVFTPESGLQLRLN EKLGTTAATELKKLDFKVSSTSNNLISTIPSDNLAAGTDNTSSLGPPSMPVHYDSQLDTTLFGKKSSPLETSGGPLSLSEENNDSK LLESGLMNSQESSWGKNVSSTESGRLFKGKRAHGPALLTKDNALFKVSISLLKTNKTSNNSATNRKTHIDGPSLLIENSPSVWQNI LESDTEFKKVTPLIHDRMLMDKNATALRLNHMSNKTTSSKNMEMVQQKKEGPIPPDAQNPDMSFFKMLFLPESARWIQRTHGKNSL NSGQGPSPKQLVSLGPEKSVEGQNFLSEKNKVVVGKGEFTKDVGLKEMVFPSSRNLFLTNLDNLHENNTHNQEKKIQEEIEKKITL IQENVVLPQIHTVTGTKNFMKNLFLLSTRQNVEGSYDGAYAPVLQDFRSLNDSTNRTKKHTAHFSKKGEEENLEGLGNQTKQIVEK YACTTRISPNTSQQNFVTQRSKRALKQFRLPLEETELEKRIIVDDTSTQWSKNMKHLTPSTLTQIDYNEKEKGAITQSPLSDCLTR SHSIPQANRSPLPIAKVSSFPSIRPIYLTRVLFQDNSSHLPAASYRKKDSGVQESSHFLQGAKKNNLSLAILTLEMTGDQREVGSL GTSATNSVTYKKVENTVLPKPDLPKTSGKVELLPKVHIYQKDLFPTETSNGSPGHLVLVEGSLLQGTEGAIKWNEANRPGKVPFLR VATESSAKTPSKLLDPLAWDNHYGTQIPKEEWKSQEKSPEKTAFKKKDTILSLNACESNHAIAAINEGQNKPEIEVTWAKQGRTER LCSQNPPVLKRHQREITRTTLQSGQEEIDYDDTISVEMKKEDFDIYDEDENQSPRSFQKKTRHYFIAAVERLWDYGMSSSPHVLRN RAQSGSVPQFKKVVFQEFTDGSPTQPLYRGELNEHLGLLGPYIRAEVEDNIMVTFRNQASRPYSFYSSLISYEEDQRQGAEPRKNF VKPNETKTYFWKVQHHMAPTKDEFDCKAWAYFSDVDLEKDVHSGLIGPLLVCHTNTLNPAHGRQVTVQEPALFFTIFDETKSWYFT ENMERNCRAPCNIQMEDPTFKENYRFHAINGYIMDTLPGLVMAQDQRIRWYLLSMGSNENIHSIHFSGHVFTVRKKEEYKMALYNL YPGVFETVEMLPSKAGIWRVECLIGEHLHAGMSTLFLVYSNKCQTPLGMASGHIRDFQITASGQYGQWAPKLARLHYSGSINAWST KEPFSWIKVDLLAPMIIHGIKTQGARQKFSSLYISQFIIMYSLDGKKWQTYRGNSTGTLMVFFGNVDSSGIKHNIFNPPIIARYIR LHPTHYSIRSTLRMELMGCDLNSCSMPLGMESKIASDAQITASSYFTNMFATWSPSKARLHLQGRSNAWRPQVNNPKEWLQVDFQK TMKVTGVTTQGVKSLLTSMYVKEFLISSSQDGHQWTLFFQNGKVKVFQGNQDSFTPVVNSLDPPLLTRYLRIHPQSWVHQIALRME VLGCEAWDLYDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQY NSTYRVVSVLTVLHQDWLNGHEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWE SNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK

TABLE 5 Polynucleotide Sequences: FVII-Fc FVII-Fc Chain DNA Sequence (SEQ ID NO: 15, which encodes  SEQ ID NO: 16) <223> Full Length FVII-Fc DNA Sequence <220> <221> sig_peptide <222> (1) . . . (180) <223> FVII signal <220> <221> misc_feature <222> (1402) . . . (2082) <223> Fc region atggtctccc aggccctcag gctcctctgc cttctgcttg ggcttcaggg ctgcctggct   60 gcaggcgggg tcgctaaggc ctcaggagga gaaacacggg acatgccgtg gaagccgggg  120 cctcacagag tcttcgtaac ccaggaggaa gcccacggcg tcctgcaccg gcgccggcgc  180 gccaacgcgt tcctggagga gctgcggccg ggctccctgg agagggagtg caaggaggag  240 cagtgctcct tcgaggaggc ccgggagatc ttcaaggacg cggagaggac gaagctgttc  300 tggatttctt acagtgatgg ggaccagtgt gcctcaagtc catgccagaa tgggggctcc  360 tgcaaggacc agctccagtc ctatatctgc ttctgcctcc ctgccttcga gggccggaac  420 tgtgagacgc acaaggatga ccagctgatc tgtgtgaacg agaacggcgg ctgtgagcag  480 tactgcagtg accacacggg caccaagcgc tcctgtcggt gccacgaggg gtactctctg  540 ctggcagacg gggtgtcctg cacacccaca gttgaatatc catgtggaaa aatacctatt  600 ctagaaaaaa gaaatgccag caaaccccaa ggccgaattg tggggggcaa ggtgtgcccc  660 aaaggggagt gtccatggca ggtcctgttg ttggtgaatg gagctcagtt gtgtgggggg  720 accctgatca acaccatctg ggtggtctcc gcggcccact gtttcgacaa aatcaagaac  780 tggaggaacc tgatcgcggt gctgggcgag cacgacctca gcgagcacga cggggatgag  840 cagagccggc gggtggcgca ggtcatcatc cccagcacgt acgtcccggg caccaccaac  900 cacgacatcg cgctgctccg cctgcaccag cccgtggtcc tcactgacca tgtggtgccc  960 ctctgcctgc ccgaacggac gttctctgag aggacgctgg ccttcgtgcg cttctcattg 1020 gtcagcggct ggggccagct gctggaccgt ggcgccacgg ccctggagct catggtcctc 1080 aacgtgcccc ggctgatgac ccaggactgc ctgcagcagt cacggaaggt gggagactcc 1140 ccaaatatca cggagtacat gttctgtgcc ggctactcgg atggcagcaa ggactcctgc 1200 aagggggaca gtggaggccc acatgccacc cactaccggg gcacgtggta cctgacgggc 1260 atcgtcagct ggggccaggg ctgcgcaacc gtgggccact ttggggtgta caccagggtc 1320 tcccagtaca tcgagtggct gcaaaagctc atgcgctcag agccacgccc aggagtcctc 1380 ctgcgagccc catttcccta ggacaaaact cacacatgcc caccgtgccc agctccagaa 1440 ctcctgggcg gaccgtcagt cttcctcttc cccccaaaac ccaaggacac cctcatgatc 1500 tcccggaccc ctgaggtcac atgcgtggtg gtggacgtga gccacgaaga ccctgaggtc 1560 aagttcaact ggtacgtgga cggcgtggag gtgcataatg ccaagacaaa gccgcgggag 1620 gagcagtaca acagcacgta ccgtgtggtc agcgtcctca ccgtcctgca ccaggactgg 1680 ctgaatggca aggagtacaa gtgcaaggtc tccaacaaag ccctcccagc ccccatcgag 1740 aaaaccatct ccaaagccaa agggcagccc cgagaaccac aggtgtacac cctgccccca 1800 tcccgggatg agctgaccaa gaaccaggtc agcctgacct gcctggtcaa aggcttctat 1860 cccagcgaca tcgccgtgga gtgggagagc aatgggcagc cggagaacaa ctacaagacc 1920 acgcctcccg tgttggactc cgacggctcc ttcttcctct acagcaagct caccgtggac 1980 aagagcaggt ggcagcaggg gaacgtcttc tcatgctccg tgatgcatga ggctctgcac 2040 aaccactaca cgcagaagag cctctccctg tctccgggta aa 2082

TABLE 6 Polypeptide Sequences: FVII-Fc FVII-Fc Chain Polypeptide Sequence (SEQ ID NO: 16) <211> 693 <212> PRT <213> Artificial Sequence <220> <223> Full Length FVII-Fc polypeptide <220> <221> SIGNAL <222> (1) . . . (60) <220> <221> MISC_FEATURE <222> (467) . . . (693) <223> Fc Sequence MVSQALRLLCLLLGLQGCLAAGGVAKASGGETRDMPWKPGPHRVFVTQEE AHGVLHRRRRANAFLEELRPGSLERECKEEQCSFEEAREIFKDAERTKLF WISYSDGDQCASSPCQNGGSCKDQLQSYICFCLPAFEGRNCETHKDDQLI CVNENGGCEQYCSDHTGTKRSCRCHEGYSLLADGVSCTPTVEYPCGKIPI LEKRNASKPQGRIVGGKVCPKGECPWQVLLLVNGAQLCGGTLINTIWVVS AAHCFDKIKNWRNLIAVLGEHDLSEHDGDEQSRRVAQVIIPSTYVPGTTN HDIALLRLHQPVVLTDHVVPLCLPERTFSERTLAFVRFSLVSGWGQLLDR GATALELMVLNVPRLMTQDCLQQSRKVGDSPNITEYMFCAGYSDGSKDSC KGDSGGPHATHYRGTWYLTGIVSWGQGCATVGHFGVYTRVSQYIEWLQKL MRSEPRPGVLLRAPFPDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMIS RTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVS VLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKSGPREPQVYTLPPS REDLTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSF FLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK

TABLE 7 Additional Sequences SEQ ID NO: 17 >Mature human albumin protein sequence (derived from NCBI Ref. Sequence NP_000468): RGVFRRDAHKSEVAHRFKDLGEENFKALVLIAFAQYLQQCPFEDHVKLVN EVTEFAKTCVADESAENCDKSLHTLFGDKLCTVATLRETYGEMADCCAKQ EPERNECFLQHKDDNPNLPRLVRPEVDVMCTAFHDNEETFLKKYLYEIAR RHPYFYAPELLFFAKRYKAAFTECCQAADKAACLLPKLDELRDEGKASSA KQRLKCASLQKFGERAFKAWAVARLSQRFPKAEFAEVSKLVTDLTKVHTE CCHGDLLECADDRADLAKYICENQDSISSKLKECCEKPLLEKSHCIAEVE NDEMPADLPSLAADFVESKDVCKNYAEAKDVFLGMFLYEYARRHPDYSVV LLLRLAKTYETTLEKCCAAADPHECYAKVFDEFKPLVEEPQNLIKQNCEL FEQLGEYKFQNALLVRYTKKVPQVSTPTLVEVSRNLGKVGSKCCKHPEAK RMPCAEDYLSVVLNQLCVLHEKTPVSDRVTKCCTESLVNRRPCFSALEVD ETYVPKEFNAETFTFHADICTLSEKERQIKKQTALVELVKHKPKATKEQL KAVMDDFAAFVEKCCKADDKETCFAEEGKKLVAASQAALGL SEQ ID NO: 18 >Albumin binding peptide 1 RLIEDICLPRWGCLWEDD SEQ ID NO: 19 >Albumin binding peptide 2 QRLMEDICLPRWGCLWEDDF SEQ ID NO: 20 >Albumin binding peptide 3 QGLIGDICLPRWGCLWGDSVK SEQ ID NO: 21 >Albumin binding peptide 4 GEWWEDICLPRWGCLWEEED 

What is claimed is:
 1. A fusion compound comprising a procoagulant compound fused to an immunoglobulin constant region or a portion thereof, wherein the procoagulant compound comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).
 2. A method of reducing or preventing aggregates comprising a procoagulant compound comprising fusing a procoagulant compound to an immunoglobulin constant region or a portion thereof, wherein the procoagulant compound comprises an amino acid sequence at least 95% identical to SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).
 3. The fusion compound of claim 1 or the method of claim 2, wherein the procoagulant compound comprises SRIRTVSPGSRSASGKSTCLASYCWLFWTGIA (SEQ ID NO: 3).
 4. The fusion compound of claim 1 or 3 or the method of claim 2 or 3, wherein the fusion compound forms less aggregates compared to a compound consisting of the procoagulant compound.
 5. The fusion compound of any one of claims 1, 3, 4, or the method of any one of claims 2 to 4, wherein the fusion compound forms at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 100% less aggregates compared to a compound consisting of the procoagulant compound.
 6. The fusion compound of any one of claims 1 and 3 to 5 or the method of any one of claims 2 to 5, wherein the immunoglobulin constant region or a portion thereof is an Fc fragment or an FcRn binding ligand.
 7. The fusion compound of any one of claims 1 and 3 to 6 or the method of any one of claims 2 to 6, wherein the procoagulant compound is linked to the immunoglobulin constant region or a portion thereof by a linker.
 8. The fusion compound or the method of claim 7, wherein the linker comprises (GGGGS)_(n), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or
 10. 9. The fusion compound or the method of claim 8, wherein the linker comprises (GGGGS)₆.
 10. The fusion compound of any one of claims 1, and 3 to 9 or the method of any one of claims 2 to 9, wherein the fusion compound further comprises an additional immunoglobulin constant region or a portion thereof, wherein the additional immunoglobulin constant region or a portion thereof is covalently linked to the immunoglobulin constant region or a portion thereof.
 11. The fusion compound or the method of claim 10, wherein the additional immunoglobulin constant region or a portion thereof is linked to the immunoglobulin constant region or a portion thereof by a second linker.
 12. The fusion compound or the method of claim 11, wherein the second linker is (GGGGS)_(n), wherein n is 1, 2, 3, 4, 5, 6, 7, 8, 9, or
 10. 13. The fusion compound or the method of claim 12, wherein the second linker is (GGGGS)₄.
 14. The fusion compound of any one of claims 1 and 3 to 13 or the method of any one of claims 2 to 13, wherein the fusion compound comprises amino acids 22 to 558 of SEQ ID NO:
 2. 15. The fusion compound of any one of claims 1 and 3 to 14 or the method of any one of claims 2 to 14, wherein the fusion compound is encoded by a nucleotide sequence of SEQ ID NO:
 1. 16. The fusion compound of any one of claims 1 and 3 to 15 and the method of any one of claims 2 to 15, wherein the fusion compound further comprises a heterologous moiety.
 17. The fusion compound or the method of claim 16, wherein the heterologous moiety comprises a polypeptide comprising FVIII, FIX, FVIIa, or a platelet targeting moiety, wherein the polypeptide is linked to the compound or to the additional immunoglobulin constant region or a portion thereof via a third, optional linker.
 18. The fusion compound or the method of claim 16 or 17, wherein the heterologous moiety is a half-life extending moiety.
 19. A polynucleotide sequence encoding the fusion compound of any one of claims 1 and 3 to
 18. 20. The polynucleotide sequence of claim 19, which comprises SEQ ID NO:
 1. 21. A vector comprising the nucleotide sequence of claim 19 or
 20. 22. A pharmaceutical composition comprising the fusion compound of any one of claims 1 and 3 to 18, the polynucleotide sequence of claim 19 or 20, or the vector of claim 21 and a pharmaceutically acceptable carrier.
 23. A host cell comprising the polynucleotide of claim 19 or 20 or the vector of claim
 21. 24. A method of making a fusion compound comprising a procoagulant compound fused to an immunoglobulin constant region or a portion thereof, the method comprising culturing the host cell of claim 23 under suitable condition, wherein the fusion compound is expressed.
 25. The method of claim 24, wherein the fusion compound forms less aggregates compared to a protein consisting of the procoagulant compound.
 26. A method of reducing, ameliorating, or preventing a bleeding episode in a subject in need thereof comprising administering the fusion compound of any one of claims 1 and 3 to 18, the polynucleotide sequence of claim 19 or 20, the vector of claim 21, or the host cell of claim
 23. 